Neuroblastoma: imaging evaluation by sequential Tc-99m MDP, I-131 MIBG, and Ga-67 citrate studies.

Abstract

Fourteen children with histopathologically confirmed neuroblastoma underwent sequential correlative imaging studies using I-131 MIBG, Tc-99m MDP, and Ga-67 citrate during various stages of the disease. Of the patients 86% showed I-131 MIBG accumulation in the primary tumoral site, whereas 71% showed Tc-99m MDP and 79% Ga-67 citrate uptake. In 86% at least one of the two latter radiopharmaceuticals concentrated in the primary tumor. The use of all three radiopharmaceuticals raised the detection rate to 93%. Of the osseous or extraosseous metastases 100% were detected by Tc-99m MDP studies. The I-131 MIBG studies were positive in 71% of the osseous metastases and in 70% of the extraosseous metastases. No Ga-67 citrate uptake was demonstrated in osseous metastases, although one extraosseous lung metastasis concentrated this radiopharmaceutical. Tc-99m MDP bone imaging was the best method for diagnosing metastatic spread of the disease and for monitoring the results of treatment. Primary tumor uptake was best indicated by I-131 MIBG. Both Ga-67 citrate and I-131 MIBG were superior to Tc-99m MDP with regard to accurately demonstrating the extent of primary tumors. Only Tc-99m MDP indicated the relationship of these tumors to the kidneys and neighboring osseous structures, providing early screening of kidney compression. Ga-67 citrate study was mainly indicated in tumors with catecholamine depletion, which failed to concentrate the other two radiopharmaceuticals. I-131 MIBG proved especially useful in detecting neuroblastoma with negative Tc-99m MDP and Ga-67 citrate studies and also proved to be helpful with those cases in which I-131 MIBG was planned for therapy. The following strategy is suggested for evaluating neuroblastoma.(ABSTRACT TRUNCATED AT 250 WORDS)

• Authors: I Garty, A Friedman, M P Sandler, A Kedar
• Journal: Clinical nuclear medicine (Clin Nucl Med) Vol. 14 Issue 7 Pg. 515-22 (Jul 1989) ISSN: 0363-9762 [Print] United States
• PMID: 2766633 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Citrates
• Gallium Radioisotopes
• Iodine Radioisotopes
• Iodobenzenes
• Citric Acid
• 3-Iodobenzylguanidine
• Technetium Tc 99m Medronate

Topics

• 3-Iodobenzylguanidine
• Bone and Bones (diagnostic imaging)
• Child
• Child, Preschool
• Citrates
• Citric Acid
• Female
• Gallium Radioisotopes
• Humans
• Infant
• Iodine Radioisotopes
• Iodobenzenes
• Male
• Neuroblastoma (diagnostic imaging, secondary)
• Radionuclide Imaging
• Technetium Tc 99m Medronate