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123I-MIBG scintigraphy/SPECT versus 18F-FDG PET in paediatric neuroblastoma

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To analyse different uptake patterns in 123I-MIBG scintigraphy/SPECT imaging and 18F-FDG PET in paediatric neuroblastoma patients.

Methods

We compared 23 123I-MIBG scintigraphy scans and 23 18F-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 18F-FDG PET were a 123I-MIBG-negative tumour, a discrepancy in 123I-MIBG uptake compared to the morphological imaging or imaging results inconsistent with clinical findings. A lesion was found by 123I-MIBG scintigraphy and/or 18F-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 123I-MIBG scintigraphy and 18F-FDG PET were 50% and 78% and the specificities were 75% and 92%, respectively. False-positive results (three 123I-MIBG scintigraphy, one 18F-FDG PET) were due to physiological uptake or posttherapy changes. False-negative results (23 123I-MIBG scintigraphy, 10 18F-FDG PET) were due to low uptake and small lesion size. Combined 123I-MIBG scintigraphy/18F-FDG PET imaging showed the highest sensitivity of 85%. In 34 lesions the 123I-MIBG scintigraphy and morphological imaging findings were discrepant. 18F-FDG PET correctly identified 32 of the discrepant findings. Two bone/bone marrow metastases were missed by 18F-FDG PET.

Conclusion

123I-MIBG scintigraphy and 18F-FDG PET showed noticeable differences in their uptake patterns. 18F-FDG PET was more sensitive and specific for the detection of neuroblastoma lesions. Our findings suggest that a 18F-FDG PET scan may be useful in the event of discrepant or inconclusive findings on 123I-MIBG scintigraphy/SPECT and morphological imaging.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Ludwig Maximilian University of Munich, Ziemssenstraße 1, 80336, Munich, Germany

    Henriette Ingrid Melzer, Peter Bartenstein & Thomas Pfluger

  2. Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany

    Eva Coppenrath

  3. Department of Paediatric Haematology/Oncology, Ludwig Maximilian University of Munich, Munich, Germany

    Irene Schmid & Michael H. Albert

  4. Department of Paediatric Surgery, Ludwig Maximilian University of Munich, Munich, Germany

    Dietrich von Schweinitz

  5. Department of Nuclear Medicine, Royal Children’s Hospital, Melbourne, VIC, Australia

    Coral Tudball

Authors
  1. Henriette Ingrid Melzer
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  2. Eva Coppenrath
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  3. Irene Schmid
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Correspondence to Henriette Ingrid Melzer.

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Melzer, H.I., Coppenrath, E., Schmid, I. et al. 123I-MIBG scintigraphy/SPECT versus 18F-FDG PET in paediatric neuroblastoma. Eur J Nucl Med Mol Imaging 38, 1648–1658 (2011). https://doi.org/10.1007/s00259-011-1843-8

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  • DOI: https://doi.org/10.1007/s00259-011-1843-8

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