Correlation of Early Metastatic Response by¹²³I-Metaiodobenzylguanidine Scintigraphy With Overall Response and Event-Free Survival in Stage IV Neuroblastoma

Abstract

Semiquantitative MIBG score early in therapy provides valuable prognostic information for overall response and EFS, which may be useful in tailoring treatment.

Tandem high-dose chemotherapy strategy as first-line treatment of primary disseminated multifocal Ewing sarcomas in children, adolescents and young adults

“…20 To optimise the detection of a good-quality remission before HDC, further investigations are warranted using PET-CT in extra-pulmonary metastatic ES, in a similar manner to MIBG scintigraphy in neuroblastoma. 21 Several studies have shown greater sensitivity of PET-CT for the detection of lymph node or bone metastases, including in ES. 22,23 The use of PET-CT response (PERCIST 15 ) to guide ES treatment has so far not been evaluated, whereas it is routinely used for this purpose in Hodgkin disease.…”

Long-term outcomes in children with high-risk neuroblastoma treated with autologous stem cell transplantation

“…[1][2][3][4][5][6][7][8][9][10][11] Features associated with an improved prognosis include younger age 5,7 and absence of bone marrow involvement at diagnosis, 12 early disease response 13 and a complete or near complete response following induction therapy. 6,7,10,14 A poorer prognosis has been associated with an elevated serum ferritin (4143 ng/ ml), 6 bone and BM metastasis, 6 detectable circulating NB cells at diagnosis, 15,16 persisting skeletal and BM disease at the end of induction therapy, 1,2 circulating NB cells in patients otherwise apparently disease-free 16 and high-level of NB contamination at marrow harvest.…”

Criteria for evaluation of disease extent by 123I-metaiodobenzylguanidine scans in neuroblastoma: a report for the International Neuroblastoma Risk Group (INRG) Task Force

“…To evaluate the prognostic effect of tumour burden at diagnosis and to be able to quantify response and define a partial response (50% reduction of all disease sites) by mIBG scan, semiquantitative scoring systems have been developed (Ady et al, 1995;Suc et al, 1996;Perel et al, 1999;Frappaz et al, 2000;Matthay et al, 2003b;Katzenstein et al, 2004;Messina et al, 2006;Lewington et al, 2009). This improves the concordance between readers, and enables one to differentiate a simple improvement with the disappearance of a lesion, or decreased intensity of lesions that can be subjective, from a significant response that would qualify as PR.…”

“…Previous studies have indicated that a positive mIBG scan after induction chemotherapy or just before myeloablative therapy may be a prognostic marker for a high likelihood of relapse (Ladenstein et al, 1998;Perel et al, 1999;Schmidt et al, 2008). Several publications have reported the use of semi-quantitative scoring systems to increase the precision and inter-observer reliability of this test, with success in correlating the results of mIBG scans with early response and event-free survival in some, but not all, reports (Ady et al, 1995;Suc et al, 1996;Frappaz et al, 2000;Hero et al, 2001;Matthay et al, 2003b;Katzenstein et al, 2004). As treatment of stage 4 neuroblastoma continues to be a challenge, with a high rate of relapse in bone and bone marrow, it is essential to have a quantitative and reliable measure of response in bone metastases to test the activity of new therapies for this disease (Messina et al, 2006).…”

“…Metaiodobenzylguanidine score at diagnosis may be prognostic, as higher scores, indicating a high body burden of tumour, have been associated with a poorer outcome in some studies. For example, Suc et al (1996) have shown that an initial semi-quantitative score of 44 was independently associated with failure to achieve complete remission after induction chemotherapy, although most other studies showed only a trend or no significance to the initial mIBG score (Perel et al, 1999;Matthay et al, 2003b;Katzenstein et al, 2004;Yanik et al, 2010). Ongoing prospective studies of large numbers of uniformly treated patients in North America and Europe will further elucidate the prognostic significance of the initial mIBG score.…”