title: Comparison of ¹²³I-metaiodobenzylguanidine (MIBG) and ¹³¹I-MIBG semi-quantitative scores in predicting survival in patients with stage 4 neuroblastoma: a report from the Children's Oncology Group.
abstract: BACKGROUND
  ¹²³I-metaiodobenzylguanidine (MIBG) scans are preferable to ¹³¹I-MIBG for neuroblastoma imaging as they deliver less patient radiation yet have greater sensitivity in disease detection. Both ¹²³I-MIBG and ¹³¹I-MIBG scans were used for disease assessments of neuroblastoma patients enrolled on Children's Oncology Group (COG) high-risk study A3973. The hypothesis was that ¹²³I-MIBG and ¹³¹I-MIBG scans were sufficiently similar for clinical purposes in terms of ability to predict survival.
  
  
  METHODS
  Patients enrolled on COG A3973 with stage 4 disease who completed ¹²³I-MIBG or ¹³¹I-MIBG scans at diagnosis, post-induction, post-transplant, or post-biotherapy were analyzed. The performance of the Curie score for each MIBG scan type in predicting survival was evaluated. At each time point, survival curves for ¹²³I-MIBG versus ¹³¹I-MIBG were compared using the log-rank test.
  
  
  RESULTS
  Of the 413 patients on A3973 with at least one MIBG scan, 350 were stage 4. The 5-year event-free survival (EFS) and overall survival (OS) rates were 33.4 ± 3.6% and 45.6 ± 4.0% (N = 350). At post-induction, EFS (P = 0.3501) and OS (P = 0.5337) for ¹²³I-MIBG versus ¹³¹I-MIBG were not significantly different. Similarly, comparisons at the three other time points were non-significant.
  
  
  CONCLUSIONS
  We found no evidence of a statistically significant difference in outcome by type of scan. For future survival analyses of MIBG Curie scores, ¹²³I-MIBG and ¹³¹I-MIBG results may be combined and analyzed overall, without adjustment for scan type.
authors.affiliation: Children's Oncology Group, University of Florida, Gainesville, Florida, USA. anaranjo@cog.ufl.edu
authors.forename: Arlene
authors.initials: A
authors.lastname: Naranjo
authors.forename: Marguerite T
authors.initials: MT
authors.lastname: Parisi
authors.forename: Barry L
authors.initials: BL
authors.lastname: Shulkin
authors.forename: Wendy B
authors.initials: WB
authors.lastname: London
authors.forename: Katherine K
authors.initials: KK
authors.lastname: Matthay
authors.forename: Susan G
authors.initials: SG
authors.lastname: Kreissman
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Yanik
mesh_terms: D019797:3-Iodobenzylguanidine; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007223:Infant; D007457:Iodine Radioisotopes; D008297:Male; D009447:Neuroblastoma / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000628:therapy; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012074:Remission Induction; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin