Comparison of MIBG and pentetreotide scintigraphy in children with neuroblastoma. Is the expression of somatostatin receptors a prognostic factor?
BACKGROUND
Neuroblastoma (NB) is the fourth most common pediatric malignancy and recent reports suggest a prognostic role of somatostatin receptor scintigraphy (SRS) in this disease.


METHODS
Twenty two patients (pts. mean age 43.9 months) with NB were investigated by 1-123-MIBG and SRS (In-111-pentetreotide). Twenty-seven comparative scans were evaluated and compared for catecholamin excretion, Ultrasound, CT and MRI data. The patients were then divided into three groups. I: patients with manifest disease, II: patients with relapse or minimal disease and III: patients with no evidence of disease.


RESULTS
MIBG and SRS scans were concordant in 85% (12 true positive, 7 true negative, 4 false negative). In 4 pts only the MIBG scan was positive. In 9 pts with stage I-III disease or complete remission no relapse was recorded during 19.8 months. In 4 out of 5 pts who died SRS failed to localize the tumor sites but three MIBG scans were positive. Five out of 6 pts with a relapse free interval of 7.9 months had positive SRS and MIBG scans.


CONCLUSIONS
in NB SRS can be applied as a specific imaging modality. However, in some pts SRS failed due to the lack of receptor expression. Somatostatin receptor expression seems to be related with a more favourable clinical outcome.
Kropp
J
J
University Hospital Department of Nuclear Medicine, Dresden, Germany.
Hofmann
M
M
Bihl
H
H
D019797:3-Iodobenzylguanidine; D000328:Adult; D002395:Catecholamines / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005188:False Negative Reactions; D005500:Follow-Up Studies; D006801:Humans; D007205:Indium Radioisotopes / Q000493:pharmacokinetics; D007223:Infant; D007457:Iodine Radioisotopes / Q000493:pharmacokinetics; D007462:Iodobenzenes / Q000493:pharmacokinetics; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D017481:Receptors, Somatostatin / Q000032:analysis / Q000096:biosynthesis*; D015203:Reproducibility of Results; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D013997:Time Factors; D014055:Tomography, Emission-Computed / Q000379:methods
D002395:Catecholamines; D007205:Indium Radioisotopes; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D017481:Receptors, Somatostatin; D019797:3-Iodobenzylguanidine; D013004:Somatostatin; C081788:pentetreotide