Diagnostic Use of Post-therapy 131I-Meta-Iodobenzylguanidine Scintigraphy in Consolidation Therapy for Children with High-Risk Neuroblastoma

Abstract

123I-meta-iodobenzylguanidine (123I-mIBG) scintigraphy is used for evaluating disease extent in children with neuroblastoma. 131I-mIBG therapy has been used for evaluation in children with high-risk neuroblastoma, and post-therapy 131I-mIBG scintigraphy may detect more lesions compared with diagnostic 123I-mIBG scintigraphy. However, no studies have yet revealed the detection rate of hidden mIBG-avid lesions on post-therapy 131I-mIBG whole-body scan (WBS) and SPECT images in neuroblastoma children without mIBG-avid lesions as demonstrated by diagnostic 123I-mIBG scintigraphy. We retrospectively examined the diagnostic utility of post-therapy 131I-mIBG scintigraphy in children who received 131I-mIBG as consolidation therapy. Nineteen children with complete response to primary therapy were examined. Post-therapy 131I-mIBG scintigraphy was performed four days after injection. The post-therapy 131I-mIBG scintigraphy, 4 children exhibited abnormal uptake on the WBS. Post-therapy 131I-mIBG SPECT/CT provided additional information in 2 cases. In total, 6 children exhibited abnormal uptake. The site of abnormal accumulation was on the recurrence site in one case, operation sites in five cases, and bone metastasis in one case. Post-therapy 131I-mIBG scintigraphy could detect residual disease that was not recognized using diagnostic 123I-mIBG scintigraphy in 32% of children with high-risk neuroblastoma and ganglioneuroblastoma. The diagnostic use of post-therapy 131I-mIBG scintigraphy can provide valuable information for detecting residual disease.

Dinutuximab beta plus conventional chemotherapy for relapsed/refractory high-risk neuroblastoma: A single-center experience

“…Despite all advances in NB treatment, relapsed/refractory disease still remains the major obstacle to cure (14-16). To date, several salvage therapies including ifosfamide, carboplatin, and etoposide (ICE) (17); topotecan and cyclophosphamide (18,19); vincristine, topotecan and cyclophosphamide (TVC) (20); topotecan and cyclophosphamide and etoposide (21); temozolomide and topotecan (TOTEM) (22); irinotecan and temozolomide (with or without bevacizumab) (23)(24)(25); topotecan, vincristine, and doxorubicin (TVD) (26,27), and the high-dose 131 I-MIBG therapy (28) have been widely used for the treatment of R/R HR-NB; however, the response rates are unsatisfactory. Although anti-GD2 monoclonal antibodies (mAbs) were initially approved to treat minimal residual disease, recent studies with anti-GD2 mAbs have been performed in HR-NB patients with intractable mass of soft tissue or bone/bone marrow disease.…”

Nonspecific Gastrointestinal Symptoms as the First Sign of Ganglioneuroblastoma Intermixed—Case Report and Literature Review

“…MIBG is taken up by norepinephrine transporters, which is demonstrated in up to 90% of NBs [ 47 ]. In 32% of children with high-risk NBs and GNBs, follow-up 131I-mIBG scintigraphy after treatment could reveal residual disease that was not identified using diagnostic 123I-mIBG scintigraphy [ 48 ]. In contrast, 123I-mIBG is used in the evaluation of bone marrow metastases [ 44 ].…”

Hyperbaric oxygen therapy as a complementary treatment in neuroblastoma — a narrative review

“…In a combination regimen, the pooled occurrence rates of thrombocytopenia and neutropenia were 79% and 78% (7). The primary underlying mechanism relies on the augmented expression of noradrenaline transporters, which enhances 131 I-MIBG intake into tumor cells (7)(8)(9)(10)(11)(12)(13).…”