Clinical impact and prognostic value of metaiodobenzylguanidine imaging in children with metastatic neuroblastoma.
OBJECTIVE
The clinical value of metaiodobenzylguanidine (mIBG) scintigraphy in patients with disseminated neuroblastoma (NB) at the time of diagnosis and after induction chemotherapy was evaluated.


METHODS
The medical records and imaging studies of 30 patients with stage 4 NB who underwent mIBG scintigraphy and 99mTc hydroxy methylene diphosphonate bone scintigraphy at the time of diagnosis were reviewed. Scores were calculated for the mIBG and bone scintigrams, and outcome according to the initial and follow-up imaging studies was determined.


RESULTS
Discrepancies between bone scintigraphy and mIBG osteomedullary localization were seen in six patients. For the entire cohort, 2-year event-free survival did not significantly differ for the group of patients with initial mIBG or bone scintigraphy scores > or = 10 compared to those with scores < 10 (P = 0.23 and 0.61, respectively). However, for patients older than 1 year, a trend associating worse outcome with mIBG scores > or = 10 at diagnosis was seen (P = 0.08). A trend correlating abnormal mIBG scintigraphy after induction therapy and poor outcome was also observed (P = 0.09). Outcome did not correlate with the results of the bone scintigram studies performed after induction chemotherapy (P = 0.68).


CONCLUSIONS
Because a discordance between mIBG and bone scintigraphy results were seen in a subset of stage 4 NB patients, both imaging studies should be performed at the time of diagnosis. mIBG imaging studies performed at the time of diagnosis and after induction chemotherapy may be of prognostic value, particularly in stage 4 patients older than 1 year.
Department of Pediatrics, Northwestern University Medical School, Chicago, Illinois, USA.
Y
Y
Perel
J
J
Conway
M
M
Kletzel
J
J
Goldman
S
S
Weiss
A
A
Feyler
S L
SL
Cohn
D019797:3-Iodobenzylguanidine; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012074:Remission Induction; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives*
D019275:Radiopharmaceuticals; C052435:technetium Tc 99m (Sn) hydroxymethylene diphosphonate; D019797:3-Iodobenzylguanidine; D013669:Technetium Tc 99m Medronate