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

Abstract EN

Background : For more than ten years.

MIBG has been successfully used in diagnosis and staging of children with neuroblastoma [1].

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 4.7years ± 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 1311 MIBG in 3 / 4 patients with a specificity of 75 %, a PPV of 88 % and NPV of 86.7 %.

1311 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 : 131I 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.