Special Articles

3. Search for neuroblastoma with ¹²³I-MIBG

Mayuki Uchiyama, Kumiko Nozawa 1）, Eiji Oguma 1）
Department of Radiology, The Jikei University School of Medicine
Department of Radiology, Saitama Children’s Medical Center 1）

Abstract

　　Neuroblastoma is a frequent tumor of childhood and remains a leading cause of death despite treatment intensification. Radioiodinated metaiodobenzylguanidine（MIBG）scintigraphy is a highly sensitive and specific method for diagnosing, staging and monitoring response to therapy. A common metastatic site of neuroblastoma is bone. It has been observed on MIBG and MRI that in the early stage, bone marrow metastases are nodular, and along with progress of the disease, they become diffuse and invade the bone cortex. The combination of MIBG and methylene diphosphonate（MDP）bone scan is useful to make a differential diagnosis between bone marrow metastasis and bone marrow and cortex metastasis. Our assessment is that the lesion with MIBG positive and MDP negative is bone marrow metastasis and that with MIBG positive and MDP positive is bone marrow and cortex metastasis. MRI or other diagnostic tools are highly sensitive to detect bone metastasis, but it is not so easy to prove disappearance of bone metastasis in the whole skeletal system including carpal and tarsal bones. MIBG scintigraphy is valuable for monitoring the response to treatment and detecting early relapse, especially in the whole skeletal system.

Keywords：Neuroblastoma, ¹²³I-MIBG scintigraphy, Bone scan