Radiology, Vol 184, 463-467, Copyright © 1992 by Radiological Society of North America
Neuroblastoma: dose-related sensitivity of MIBG scanning in detection
MT Parisi, KK Matthay, JP Huberty and RS Hattner
Department of Radiology, University of California, San Francisco.
Iodine-131 metaiodobenzylguanidine (MIBG) has shown effectiveness as a
systemic radiotherapeutic agent in neuroblastoma. The authors postulated a
likely dose-related relationship of MIBG sensitivity when it was
administered for neuroblastoma detection. They studied this relationship in
neuroblastoma patients who underwent scanning after receiving diagnostic
and therapeutic doses of MIBG in temporal proximity. Seven patients with
stage IV disease received a total of 14 therapeutic administrations of
I-131 MIBG (150-350 mCi [5,550-12,950 MBq]/m2 per treatment). Posttherapy
scans were obtained at 3 and at 5-7 days. Diagnostic MIBG scans had been
obtained no more than 4 weeks before the start of therapy. Use of
diagnostic MIBG scanning led to underestimation of the tumor burden by 50%
compared with use of posttherapy scanning. This difference may be an
important consideration in selecting therapeutic strategies for individual
patients. It further suggests that use of much larger diagnostic doses of
MIBG is a rational strategy in histologically confirmed cases of advanced
disease.
