Berg Sarah,  States Lisa

Final Pr. ID: Poster #: EDU-083

Neuroblastoma, the most common extracranial solid tumor in children, arises from embryonal neural crest progenitor cells. With a common origin of neuroendocrine cytology, this otherwise highly variable disease can be imaged with high sensitivity by exploiting the underlying biochemistry of the nervous system – namely with radiolabeled I-123 metaiodobenzylguanidine (MIBG), a norepinephrine analog. Imaging with MIBG over time can serve several key roles, including providing accurate stage at diagnosis, response assessment following therapy, and detection of recurrent disease. Moreover, when using the Curie score, a standardized and validated assessment of MIBG uptake on planar imaging, valuable prognostic information can be elucidated both at time of diagnosis and following induction therapy. Through the utilization of the same underlying physiologic principles, I-131 MIBG could be administered for an intended therapeutic effect, targeting sites of tracer uptake. The purpose of this educational exhibit is to review the process of quantifying and assigning a Curie score in the evaluation of pediatric neuroblastoma using I-123 MIBG planar imaging. Using a pictorial review of various I-123 MIBG positive cases, we will highlight normal MIBG uptake, distribution, and excretion. Through the inclusion of case examples that demonstrate various stages of disease, differing sites and severity of pathologic activity will be highlighted. Finally, the prognostic significance of the Curie scoring paradigm over time will be illustrated, specifically at the time of diagnosis and post-induction with I-123 MIBG, and in the post-therapy setting with I-131 MIBG. Read More

Authors:  Berg Sarah , States Lisa

Keywords:  Nuclear Medicine, MIBG, Neuroblastoma

Kong Melissa,  Potts James,  Nadel Helen

Final Pr. ID: Poster #: SCI-064

In the past, neuroblastoma patients frequently had mIBG and diagnostic CT scans performed at separate times. This practice sometimes caused issues in correlating findings from the two imaging modalities. A retrospective review of our entire experience aimed to confirm the added value of optimized co-registered contrast-enhanced diagnostic CT to I-123 mIBG SPECT/CT protocol in children with neuroblastoma. An additional objective was to identify if SPECT/CT improved Curie score assignment vs planar imaging. Read More

Authors:  Kong Melissa , Potts James , Nadel Helen

Keywords:  SPECT/CT, mIBG, Neuroblastoma

Lai Lillian,  Berkovich Rachel,  Goodarzian Fariba

Final Pr. ID: Poster #: EDU-081

The purpose of this exhibit is explore pitfalls in our experience with SPECT-CT Iodine-123 (I-123) MIBG imaging in patients with neuroblastoma. SPECT-CT can more specifically localize areas of uptake over planar imaging and mitigate false-positive results with correlative anatomic information. We will review cases of false-positive MIBG uptake in nonmalignant sites, cases of false-negative MIBG uptake in neuroblastoma/neural crest tumors, and cases of secondary tumors/malignancies occurring in the setting of known neuroblastoma, with variable uptake on MIBG. Read More

Authors:  Lai Lillian , Berkovich Rachel , Goodarzian Fariba

Keywords:  MIBG, neuroblastoma, SPECT-CT