Role of radio-iodinated meta-iodo benzyl guanidine in assessment of children with neuroblastoma at NEMROCK.

Abstract

BACKGROUND:

For more than ten years. MIBG has been successfully used in diagnosis and staging of children with neuroblastoma.

AIM OF THE STUDY:

Identify the role of 131I MIBG in the assessment of neuroblastoma and correlate its findings with other non-invasive tests.

PATIENTS AND METHODS:

Twenty eight patients with neuroblastoma attending the Pediatric Oncology Unit, Kasr El-Aini Center of Radiation Oncology and Nuclear Medicine (NEMROCK), Cairo University, over a period of 5 years (2002-2006) were assessed by MIBG scanning. The age of patients ranged from 40 days to 12 years with a mean of 4.7 years +/- 1.1. They were 16 boys and 12 girls with a M:F ratio of 1:3, none was stage I and II, 7 patients (25%) were stage III and 21 patients (75%) were stage IV (Evan's staging system). Clinically, 24 patients (85.7%) presented with an abdominal mass, and 3 patients (10.7%) with a mediastinal mass. Metastases were present in the bone marrow in 11 children (39.3%), lymph nodes in 5 (17.9%), CNS in 4 (14.3%), liver in 2 (7.1%), soft tissues in 3 (10.7%), lungs and pleura in 1 (3.6%), brain in 1 (3.6%), and testis in 1 patient (3.8%).

RESULTS:

131I MIBG could accurately diagnose local and distant neuroblastoma lesions in 23 patients with a sensitivity of 82.2%. High levels of VMA correlated with no cardiac uptake in the first 24 hours in 7/8 patients with a sensitivity of 87.5%. On the other hand, low VMA levels were associated with cardiac uptake of (131)I MIBG in 3/4 patients with a specificity of 75%, a PPV of 88% and NPV of 86.7%. (131)I MIBG scintigraphy and bone marrow aspiration agreed on detecting neuroblastoma lesions in 24 /28 patients (85.7%) p<0.01, with a sensitivity of 59.5%, specificity of 96.6%. PPV of 89.3%, and NPV of 83.2%.

CONCLUSION:

(131)I MIBG scintigraphy, in a dose of 2 mci can be used with 87.5% accuracy in the diagnosis and follow-up of Children with neuroblastoma.

• Authors: Hesham Abd El-Aal
• Journal: Journal of the Egyptian National Cancer Institute (J Egypt Natl Canc Inst) Vol. 18 Issue 4 Pg. 375-81 (Dec 2006) ISSN: 1110-0362 [Print] England
• PMID: 18301461 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Iodine Radioisotopes
• 3-Iodobenzylguanidine

Topics

• 3-Iodobenzylguanidine (pharmacokinetics)
• Abdominal Neoplasms (diagnosis, pathology)
• Biopsy, Needle
• Bone Marrow (pathology)
• Bone and Bones (drug effects, metabolism)
• Child
• Child, Preschool
• Egypt
• Female
• Heart (drug effects)
• Humans
• Infant
• Iodine Radioisotopes
• Male
• Mediastinal Neoplasms (diagnosis, pathology)
• Myocardium (metabolism)
• Neoplasm Staging
• Neuroblastoma (diagnosis, pathology)
• Retrospective Studies
• Sensitivity and Specificity