Molecular Imaging and Biology

, Volume 10, Issue 1, pp 19–23 | Cite as

123I MIBG Mapping with Intraoperative Gamma Probe for Recurrent Neuroblastoma

  • Andrei Iagaru
  • David Peterson
  • Andrew Quon
  • Sanjeev Dutta
  • Claire Twist
  • Farhdad Daghighian
  • Sanjiv Sam GambhirEmail author
  • Craig Albanese
Rapid Communication


Intraoperative gamma probe guidance has become widely utilized for sentinel lymph node dissection in patients with breast cancer and melanoma, using 99mTc sulfur colloid. However, new indications are possible and need to continue to be investigated. We report the use during a wedge liver biopsy of a new hand-held gamma probe designed for 123I intraoperative guidance. The patient studied is a 5-year-old boy with history of stage 4 high-risk neuroblastoma. Anatomic imaging (CT, MRI), 99mTc bone scintigraphy and 2-deoxy-2-[F-18]fluoro-d-glucose—positron emission tomography/computed tomography (FDG-PET/CT) were negative, but the 123I MIBG scintigraphy suggested recurrent liver disease. A decision was made to biopsy these lesions to obtain histopathological confirmation. Intraoperative gamma probe mapping of the liver identified areas with signal above the background, but these were prove to be hemosiderin deposits on histo-pathology examination.

Key words

Neuroblastoma Gamma probe Intra-operative 123I 


  1. 1.
    Grovas A, Fremgen A, Rauck A, et al. (1997) The National Cancer Data Base report on patterns of childhood cancers in the United States. Cancer 80:2321–2332, Dec 15PubMedCrossRefGoogle Scholar
  2. 2.
    Gurney JG, Ross JA, Wall DA, et al. (1997) Infant cancer in the U.S.: histology-specific incidence and trends, 1973 to 1992. J Pediatr Hematol Oncol 19:428–432PubMedCrossRefGoogle Scholar
  3. 3.
    Heij HA, Rutgers EJ, de Kraker J, Vos A (1997) Intraoperative search for neuroblastoma by MIBG and radioguided surgery with the gamma detector. Med Pediatr Oncol 28:171–174, MarPubMedCrossRefGoogle Scholar
  4. 4.
    Matthay KK, Villablanca JG, Seeger RC, et al. (1999) Treatment of high-risk neuroblastoma with intensive chemotherapy, radiotherapy, autologous bone marrow transplantation, and 13-cis-retinoic acid. Children’s Cancer Group. N Engl J Med 341:1165–1173, Oct 14PubMedCrossRefGoogle Scholar
  5. 5.
    Kushner BH (2004) Neuroblastoma: A disease requiring a multitude of imaging studies. J Nucl Med 45:1172–1188, JulPubMedGoogle Scholar
  6. 6.
    Mehta K, Haller JO, Legasto AC (2003) Imaging neuroblastoma in children. Crit Rev Comput Tomogr 44:47–61PubMedCrossRefGoogle Scholar
  7. 7.
    Hoffer FA (2005) Magnetic resonance imaging of abdominal masses in the pediatric patient. Semin Ultrasound CT MR 26:212–223, AugPubMedCrossRefGoogle Scholar
  8. 8.
    Aarsvold JN, Alazraki NP (2005) Update on detection of sentinel lymph nodes in patients with breast cancer. Semin Nucl Med 35:116–128, AprPubMedCrossRefGoogle Scholar
  9. 9.
    Cohen MB, A-Kader HH, Lambers D, Heubi JE. (1992) Complications of percutaneous liver biopsy in children. Gastroenterology 102:629–632, FebPubMedGoogle Scholar
  10. 10.
    van der Poorten D, Kwok A, Lam T, et al. (2006) Twenty-year audit of percutaneous liver biopsy in a major Australian teaching hospital. Intern Med J 36:692–699, NovPubMedCrossRefGoogle Scholar
  11. 11.
    Dessner DA, DiPietro MA, Shulkin BL. (1993) MIBG detection of hepatic neuroblastoma: Correlation with CT, US and surgical findings. Pediatr Radiol 23:276–280PubMedCrossRefGoogle Scholar
  12. 12.
    Pfluger T, Schmied C, Porn U, et al. (2003) Integrated imaging using MRI and 123I metaiodobenzylguanidine scintigraphy to improve sensitivity and specificity in the diagnosis of pediatric neuroblastoma. AJR Am J Roentgenol 181:1115–1124, OctPubMedGoogle Scholar

Copyright information

© Academy of Molecular Imaging 2007

Authors and Affiliations

  • Andrei Iagaru
    • 1
  • David Peterson
    • 2
  • Andrew Quon
    • 1
  • Sanjeev Dutta
    • 2
  • Claire Twist
    • 3
  • Farhdad Daghighian
    • 4
  • Sanjiv Sam Gambhir
    • 5
    Email author
  • Craig Albanese
    • 2
  1. 1.Department of Radiology, Division of Nuclear MedicineStanford University Medical CenterStanfordUSA
  2. 2.Department of Pediatric SurgeryStanford University Medical CenterStanfordUSA
  3. 3.Department of Pediatric OncologyStanford University Medical CenterStanfordUSA
  4. 4.Intra-Medical Imaging LLCLos AngelesUSA
  5. 5.Departments of Radiology and BioengineeringStanford University Medical CenterStanfordUSA

Personalised recommendations