Iodine-123-MIBG SPECT versus planar imaging in children with neural crest tumors.
Iodine-123-metaiodobenzylguanidine (MIBG) SPECT was compared with 123I-MIBG planar imaging in 35 studies of 25 children with neural crest tumors.


METHODS
Iodine-123-MIBG (0.070-0.140 mCi/kg intravenously) was followed at 24 hr by wholebody planar imaging and triple-detector, high-resolution thoraco-abdominal SPECT. At 48 hr, thoracoabdominal planar imaging was performed whenever a high-tissue background or gut activity interfered with the interpretation of the 24-hr planar images. SPECT views included a cine loop presentation of multiple volume-rendered projections. Two reviewers enumerated the number of abnormal sites on the planar and SPECT studies and rated the certainty of interpretation for each study on a scale from 0.1 (low certainty) to 1.0 (high).


RESULTS
Abnormal uptake was noted on planar or SPECT imaging in 13 studies (seven patients). The average number of abnormal sites detected per study for all 35 studies was 2.7 for planar imaging and 2.9 for SPECT (p = not significant) (and 7.2 and 8.4 for planar and SPECT, respectively, for the 13 abnormal studies.) The certainty ratings for all 35 studies were 0.74 for planar studies, 0.82 for SPECT (p = 0.05, chi-square, compared with planar) and 0.86 for planar and SPECT combined (p = 0.01 compared with planar alone). On volume-rendered images, gut activity was seen as diffuse and/or linear intraluminal activity.


CONCLUSIONS
When 123I-MIBG SPECT is used, the number of lesions detected is not increased, but there is a significant improvement in the certainty of interpretation over planar imaging.
Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229.
M J
MJ
Gelfand
A H
AH
Elgazzar
V M
VM
Kriss
P R
PR
Masters
G J
GJ
Golsch
D019797:3-Iodobenzylguanidine; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D009432:Neural Crest; D009447:Neuroblastoma / Q000000981:diagnostic imaging*; D010673:Pheochromocytoma / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013565:Sympatholytics; D015899:Tomography, Emission-Computed, Single-Photon
D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D013565:Sympatholytics; D019797:3-Iodobenzylguanidine