Skeletal assessment in neuroblastoma--the pitfalls of iodine-123-MIBG scans.
This study was carried out to compare iodine-123 metaiodobenzylguanidine ([I123I]MIBG) and technetium-99m-methylene diphosphonate bone scans (99mTc-MDP) in the detection of skeletal involvement by neuroblastoma. Forty-four children with neuroblastoma underwent both [123I] MIBG and 99mTc-MDP scans within a 4-wk period; bone marrow examination also was performed; all these investigations were done both at diagnosis and at follow-up. At diagnosis, four children with Stage 4 disease had normal [123I]MIBG scans but abnormal 99mTc-MDP scans, while at follow-up there were four children with negative [123I]MIBG studies who later died from disseminated neuroblastoma. All eight scans are considered false-negative. In 24 children, the [123I]MIBG revealed more extensive disease with 161 positive sites while the 99mTc-MDP scan showed only 100 positive sites; 34 of these sites were common to both studies. This study shows that underassessment of skeletal involvement by neuroblastoma occurred using [123I]MIBG scans and that one cannot therefore substitute [123I]MIBG for 99mTc-MDP bone scans in the staging of neuroblastoma.
Gordon
I
I
Department of Radiology, Hospital for Sick Children, London, Great Britain.
Peters
A M
AM
Gutman
A
A
Morony
S
S
Dicks-Mireaux
C
C
Pritchard
J
J
D019797:3-Iodobenzylguanidine; D001853:Bone Marrow / Q000473:pathology; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D002648:Child; D002675:Child, Preschool; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D009367:Neoplasm Staging / Q000379:methods; D009447:Neuroblastoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D011877:Radionuclide Imaging; D013669:Technetium Tc 99m Medronate
D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D019797:3-Iodobenzylguanidine; D013669:Technetium Tc 99m Medronate