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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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