MIBG in Neuroblastoma Diagnostic Imaging and Therapy

Abstract

Neuroblastoma is a common malignancy observed in infants and young children. It has a varied prognosis, ranging from spontaneous regression to aggressive metastatic tumors with fatal outcomes despite multimodality therapy. Patients are divided into risk groups on the basis of age, stage, and biologic tumor factors. Multiple clinical and imaging tests are needed for accurate patient assessment. Iodine 123 ((123)I) metaiodobenzylguanidine (MIBG) is the first-line functional imaging agent used in neuroblastoma imaging. MIBG uptake is seen in 90% of neuroblastomas, identifying both the primary tumor and sites of metastatic disease. The addition of single photon emission computed tomography (SPECT) and SPECT/computed tomography to (123)I-MIBG planar images can improve identification and characterization of sites of uptake. During scan interpretation, use of MIBG semiquantitative scoring systems improves description of disease extent and distribution and may be helpful in defining prognosis. Therapeutic use of MIBG labeled with iodine 131 ((131)I) is being investigated as part of research trials, both as a single agent and in conjunction with other therapies. (131)I-MIBG therapy has been studied in patients with newly diagnosed neuroblastoma and those with relapsed disease. Development and implementation of an institutional (131)I-MIBG therapy research program requires extensive preparation with a focus on radiation protection.

Rapid Iododeboronation with and without Gold Catalysis: Application to Radiolabelling of Arenes

“…In the 123 I-form, MIBG is ac ommercially available radiopharmaceuticalt hat is used for the SPECT imaging of humann orepinephrinet ransporter-expressing cancers. [27] In the 131 I-form, MIBG is used for targeted radionuclide therapy. [28] Adi-Boc-protected boronica cid analogue of MIBG was efficiently prepared in one step by the coupling of 3-(aminomethyl)benzeneboronic acid with di-Boc-protected 1H-pyrazole-1-carboxamidine.…”

Diagnostic Value of Diffusion-Weighted MRI for Tumor Characterization, Differentiation and Monitoring in Pediatric Patients with Neuroblastic Tumors

“…3. Similarly, only 90 % of NB [21] and only 50 % of NB relapses [22] show MIBG uptake. Studies on NB patients reported high cumulative [23] and per-examination [24] doses of radiation exposure from PET/CT.…”

Evaluation of the utility of 99mTc‐MDP bone scintigraphy versus MIBG scintigraphy and cross‐sectional imaging for staging patients with neuroblastoma

“…Eighty percent of the MIBG studies included both multiprojection static planar images and SPECT imaging, while only 13% of bone scan studies were performed with both SPECT and planar imaging. Although the addition of SPECT imaging is known to increase sensitivity, not all sites of skeletal disease (i.e., the extremities) are routinely included in standard SPECT acquisition. As such, the comparisons shown here between bone and MIBG scintigraphy were based on the planar images.…”