title: ¹²³I-MIBG scintigraphy/SPECT versus ¹⁸F-FDG PET in paediatric neuroblastoma.
abstract: OBJECTIVE
  To analyse different uptake patterns in (123)I-MIBG scintigraphy/SPECT imaging and (18)F-FDG PET in paediatric neuroblastoma patients.
  
  
  METHODS
  We compared 23 (123)I-MIBG scintigraphy scans and 23 (18)F-FDG PET scans (mean interval 10 days) in 19 patients with a suspected neuroblastic tumour (16 neuroblastoma, 1 ganglioneuroblastoma, 1 ganglioneuroma and 1 opsomyoclonus syndrome). SPECT images of the abdomen or other tumour-affected regions were available in all patients. Indications for (18)F-FDG PET were a (123)I-MIBG-negative tumour, a discrepancy in (123)I-MIBG uptake compared to the morphological imaging or imaging results inconsistent with clinical findings. A lesion was found by (123)I-MIBG scintigraphy and/or (18)F-FDG PET and/or morphological imaging.
  
  
  RESULTS
  A total of 58 suspicious lesions (mean lesion diameter 3.8 cm) were evaluated and 18 were confirmed by histology and 40 by clinical follow-up. The sensitivities of (123)I-MIBG scintigraphy and (18)F-FDG PET were 50% and 78% and the specificities were 75% and 92%, respectively. False-positive results (three (123)I-MIBG scintigraphy, one (18)F-FDG PET) were due to physiological uptake or posttherapy changes. False-negative results (23 (123)I-MIBG scintigraphy, 10 (18)F-FDG PET) were due to low uptake and small lesion size. Combined (123)I-MIBG scintigraphy/(18)F-FDG PET imaging showed the highest sensitivity of 85%. In 34 lesions the (123)I-MIBG scintigraphy and morphological imaging findings were discrepant. (18)F-FDG PET correctly identified 32 of the discrepant findings. Two bone/bone marrow metastases were missed by (18)F-FDG PET.
  
  
  CONCLUSIONS
  (123)I-MIBG scintigraphy and (18)F-FDG PET showed noticeable differences in their uptake patterns. (18)F-FDG PET was more sensitive and specific for the detection of neuroblastoma lesions. Our findings suggest that a (18)F-FDG PET scan may be useful in the event of discrepant or inconclusive findings on (123)I-MIBG scintigraphy/SPECT and morphological imaging.
authors: Department of Nuclear Medicine, Ludwig Maximilian University of Munich, Ziemssenstraße 1, 80336 Munich, Germany. henriette.melzer@campus.lmu.de
authors: Henriette Ingrid
authors: HI
authors: Melzer
authors: Eva
authors: E
authors: Coppenrath
authors: Irene
authors: I
authors: Schmid
authors: Michael H
authors: MH
authors: Albert
authors: Dietrich
authors: D
authors: von Schweinitz
authors: Coral
authors: C
authors: Tudball
authors: Peter
authors: P
authors: Bartenstein
authors: Thomas
authors: T
authors: Pfluger
references: Med Pediatr Oncol. 2000 Apr;34(4):237-41
references: 10742058
references: Pediatr Blood Cancer. 2011 Oct;57(4):629-35
references: 21319289
references: Q J Nucl Med. 2003 Mar;47(1):31-40
references: 12714952
references: Q J Nucl Med Mol Imaging. 2008 Dec;52(4):403-18
references: 19088694
references: Q J Nucl Med Mol Imaging. 2010 Aug;54(4):389-400
references: 20823807
references: Eur J Cancer. 2008 Jul;44(11):1552-8
references: 18424129
references: Med Pediatr Oncol. 2000 Aug;35(2):153-5
references: 10918246
references: J Nucl Med. 1990 Feb;31(2):129-34
references: 2313350
references: Eur J Radiol. 2010 Sep;75(3):306-14
references: 19781884
references: J Clin Oncol. 2009 Mar 1;27(7):1041-6
references: 19171710
references: Clin Nucl Med. 2002 Feb;27(2):117-25
references: 11786742
references: J Clin Oncol. 1993 Aug;11(8):1466-77
references: 8336186
references: Br J Cancer. 2010 Apr 27;102(9):1319-26
references: 20424613
references: J Clin Oncol. 2009 Nov 10;27(32):5343-9
references: 19805691
references: Eur J Nucl Med Mol Imaging. 2008 Aug;35(8):1581-8
references: 18536914
references: J Clin Oncol. 2003 Mar 15;21(6):1082-6
references: 12637474
references: J Pediatr Hematol Oncol. 1999 May-Jun;21(3):181-9
references: 10363850
references: J Clin Oncol. 2010 May 20;28(15):2625-34
references: 20404250
references: Eur J Cancer. 2001 Apr;37(6):722-9
references: 11311646
references: Pediatr Blood Cancer. 2009 Apr;52(4):552
references: 19058210
references: J Nucl Med. 2009 Aug;50(8):1237-43
references: 19617326
references: Radiology. 1996 Jun;199(3):743-50
references: 8637999
references: Pediatr Blood Cancer. 2009 Jul;52(7):784-90
references: 19185008
references: J Clin Endocrinol Metab. 2010 Jun;95(6):2596-606
references: 20392867
references: Przegl Lek. 2010;67(6):387-92
references: 21344767
references: J Nucl Med. 2004 Jul;45(7):1172-88
references: 15235064
references: J Nucl Med. 1998 Apr;39(4):679-88
references: 9544682
references: J Clin Oncol. 2001 Jul 15;19(14):3397-405
references: 11454888
references: Eur J Nucl Med Mol Imaging. 2003 May;30(5):B45-50
references: 12658506
references: Q J Nucl Med Mol Imaging. 2008 Dec;52(4):388-402
references: 19088693
references: Pediatr Blood Cancer. 2008 Dec;51(6):828-31
references: 18680162
references: AJR Am J Roentgenol. 2003 Oct;181(4):1115-24
references: 14500242