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Pediatrics: diagnosis of neuroblastoma

Pediatrics: diagnosis of neuroblastoma

Authors :
Barry L. Shulkin
Michael J. Gelfand
Susan Sharp
Source :
Seminars in nuclear medicine. 41(5)
Publication Year :
2011

Abstract

Neuroblastoma is the most common pediatric extracranial soft-tissue tumor, accounting for approximately 8% of childhood malignancies. Its prognosis is widely variable, ranging from spontaneous regression to fatal disease despite multimodality therapy. Multiple imaging and clinical tests are needed to accurately assess patient risk with risk groups based on disease stage, patient age, and biological tumor factors. Approximately 60% of patients with neuroblastoma have metastatic disease, most commonly involving bone marrow or cortical bone. Metaiodobenzylguanidine (mIBG) scintigraphy plays an important role in the assessment of neuroblastoma, allowing whole-body disease assessment. mIBG is used to define extent of disease at diagnosis, assess disease response during therapy, and detect residual and recurrent disease during follow-up. mIBG is highly sensitive and specific for neuroblastoma, concentrating in >90% of tumors. mIBG was initially labeled with 131 I, but 123 I-mIBG yields higher quality images at a lower patient radiation dose. 123 I-mIBG (AdreView; GE Healthcare, Arlington Heights, IL) was approved for clinical use in children by the Food and Drug Administration in 2008 and is now commercially available throughout the United States. The use of single-photon emission computed tomography and single-photon emission computed tomography/computed tomography in 123 I-mIBG imaging has improved certainty of lesion detection and localization. Fluorodeoxyglucose positron-emission tomography has recently been compared with mIBG and found to be most useful in neuroblastomas which fail to or weakly accumulate mIBG.

Details

ISSN :
15584623
Volume :
41
Issue :
5
Database :
OpenAIRE
Journal :
Seminars in nuclear medicine
Accession number :
edsair.doi.dedup.....ce8b293a365637bd57477c5ad6bfff80