The significance of metaiodobenzylguanidine scintigraphy in the treatment of high risk neuroblastomas

Introduction: Neuroblastoma cells show the expression of norepinephrine transporters enabling the intercellular location of mIBG, which turned out to be ideal for the visualization of neuroblastoma, as well as for the treatment of these tumors in certain cases. Aim: The aim of this retrospective analysis is to show the possibilities of the 131/123J-mIBG scintigraphy in detecting primary tumor as well as in determining the presence and localization of metastatic lesions in children with neuroblastoma. Material and methods: The investigation was carried out in 17 subjects, 7 boys and 10 girls, aged 8.2 ± 7.8 (4 months to 16 years). In 10 of them the IV neuroblastoma was confirmed. A number of 7 children underwent only the diagnostic scintigraphy while in 10 of them 2-5 scans with 123/131J-mIBG were performed during follow-up. In total, there were 35 scintigraphy for the analysis. Results: A negative finding of 123/131J-mIBG scan was observed in 8 subjects. In one of them, neuroblastoma was histopathologically proven, but the scintigraphy was performed after the surgical removal of the tumor and after chemotherapy. In 9 children with scintigraphically confirmed neuroblastoma, apart from having the primary tumor, the metastatic spread of the disease was detected in the bone marrow during the initial staging. After the treatment, 4 children had a negative finding on mIBG scintigraphy, which indicated the remission, while in 2 children, the tumor relapsed; and in 4 of them, the regression of the tumor occurred after the treatment. Conclusion: The results showed high sensitivity of 123/131J-mIBG scintigraphy in detecting neuroblastoma, both the primary tumor and metastases in the bone marrow. This radiopharmaceutical turned out to be reliable for the treatment monitoring of children with neuroblastoma. Likewise, a high incidence of bone metastases was detected on the mIBG scintigraphy, as well as a the high rate of disease recurrence after therapy.