Article

Exploiting the MIBG-avidity of neuroblastoma for staging and treatment

Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Pediatric Blood & Cancer (Impact Factor: 2.39). 12/2006; 47(7):863-4. DOI: 10.1002/pbc.20821
Source: PubMed
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    ABSTRACT: The German translation of the EANM guideline for MIBG scintigraphy in children (Olivier P et al. EJNM MI 2003; 30: B45-B50; Hahn K. Der Nuklearmediziner 2002; 25: 101-105) was reviewed and actualized according to current publications, legal requirements and conditions in Germany. For the first time this guideline was generated in consensus with the neuroblastoma study group of the Association of Paediatric Haematologie and Oncology (GPOH) with the result of an interdisciplinary recommendation. Further main alterations are related to the recommended (123)I activities with respect to the new EANM Paediatric Dosage Card and the explicit recommendation of SPECT.
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    ABSTRACT: Radioiodinated metaiodobenzylguanidine (MIBG), or Iobenguane, was developed in the late 1970s at the Michigan University Medical Center for imaging the adrenal medulla and its diseases, and was rapidly extended to depict a wide range of tumors of neural crest origin. Because of its high and selective uptake and retention by these tumors, careful consideration was also given to the therapeutic potential of [(131)I]MIBG. Beside imaging and therapy of neuroendocrine tumors, the possibility of in vivo assessment of cardiac sympathetic neuronal activity led recently to a renewed interest for MIBG scintigraphy and this application is still expanding. In this paper, we review the evolution in the use of MIBG in more than 25 years of experimental and clinical applications, with attention also to the developments in radiochemistry and instrumentation. A literature search in PubMed based on ''metaiodobenzylguanidine or MIBG'' was conducted; from this analysis, it appears that the use of MIBG evolved from nearly exclusively oncology (both for diagnosis and therapy) to new applications mainly aimed to study the sympathetic neuronal integrity of the heart. Those currently exceed those about imaging of tumor diseases. We also report the geographic distribution of published papers.
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    ABSTRACT: Neuroblastoma (NBL) is the commonest extra-cranial solid tumor in children and the leading cause of cancer related deaths in childhood between the age of 1 to 4 years. NBL may behave in very different ways, from the less aggressive stage 4S NBL or congenital forms that may resolve without treatment in up to 90% of the children, to the high-risk disseminated stage 4 disease in older children with a cure rate of 35 to 40%. Initial staging is crucial for effective management and radiolabeled metaiodobenzylguanidine (MIBG) with iodine-123 is a powerful tool with a sensitivity around 90% and a specificity close to 100% for the diagnosis of NBL. MIBG scintigraphy is used routinely and is mandatory in most investigational clinical trials both for the initial staging of the disease, the evaluation of the response to treatment, as well as for the detection of recurrence during follow-up. With respect to outcome of children presenting disseminated stage 4 NBL, the role of post-therapeutic [(123)I]MIBG scan has been investigated by several groups but so far there is no consensus whereas a complete or very good partial response as assessed by MIBG may be of prognostic value. NBL needs a multimodality approach at diagnosis and during follow-up and MIBG scintigraphy keeps its pivotal role, in particular with respect to bone marrow involvement and/or cortical bone metastases.
    No preview · Article · Jan 2009 · The quarterly journal of nuclear medicine and molecular imaging: official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of...