[Value of 123I-MIBG scanning, neuron-specific enolase and serum ferritin in the diagnosis and follow-up of patients with neuroblastoma].
BACKGROUND
The neuroblastoma (NB) is one of the most common pediatric malignant neoplasms. The most commonly used tumor markers in the diagnosis and follow-up of this tumor are the serum neuron-specific enolase (NSE), ferritin and lactic dehydrogenase and urinary vanillymandelic and homovanillic acid. The common imaging modalities are CT, MRI and 123I or 131I-meta-iodobenzylguanidine scintigraphy.


OBJECTIVE
The aim of this study is to assess the value of 123I-meta-iodobenzylguanidine (MIBG) scintigraphy and serum determinations of NSE and ferritin in the diagnosis and evolution of NB patients.


METHODS
20 patients (8 female, 12 male) whose ages ranged from 2 months to 9 years with a mean age of 2.64 years diagnosed of NB. 47 123I-MIBG scans, 47 NSE determinations and 47 ferritin ones were selected.


RESULTS
At the time of diagnosis, 100% of the 123I-MIBG scans were positive. 65% of NSE determinations presented clearly pathological levels and 15% were very near to the cut-off point. Only 45% of the ferritin levels were increased. The differences between the lesions visible by 123I-MIBG scanning before and 3 months after treatment as well as NSE and ferritin levels were studied. When the Student's T test was applied, we found statistically significant pre and post-treatment differences in 123I-MIBG scanning and NSE. In the case of ferritin, there was no statistical significance in spite of the decrease in the values. The direct correlation and Spearman correlation between laboratory data and 123I-MIBG scanning as well as correlation between NSE and ferritin were also studied. There was a good correlation between 123I-MIBG and NSE and between NSE and ferritin. We have also studied the data in 7 relapses.


CONCLUSIONS
123I-MIBG scintigraphy and serum determination of NSE are two successful diagnostic tools for the diagnosis and evolution of NB patients.
Hervás Benito
I
I
Servicio de Medicina Nuclear del Hospital Universitario La Fe, Valencia. ihervas@inicia.es
Rivas Sánchez
A
A
Bello Arques
P
P
Cañete
A
A
Fernández
J M
JM
Saura Quiles
A
A
González Cabezas
P
P
Ruiz Rodríguez
J C
JC
Castell
V
V
Pérez Pastor
J L
JL
Monfort
J A
JA
Mateo Navarro
A
A
D019797:3-Iodobenzylguanidine; D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D014408:Biomarkers, Tumor / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005293:Ferritins / Q000097:blood*; D018305:Ganglioneuroblastoma / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D007223:Infant; D007457:Iodine Radioisotopes; D008297:Male; D008479:Mediastinal Neoplasms / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality; D009447:Neuroblastoma / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012186:Retroperitoneal Neoplasms / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D007457:Iodine Radioisotopes; D019797:3-Iodobenzylguanidine; D005293:Ferritins; D010751:Phosphopyruvate Hydratase