Scintigraphy for the Detection of Neuroblastoma

Thepurpose ofthisstudywastocompare theutilityofbone and metaiodobenzylguanidine (MIBG)scintigraphy for the de tection of primaryand metastatic deposits of neuroblastoma. @Tc methylene diphosphonate (MDP)bone and 131l-MIBG scans performedwithin1 mo of each other in85 patients with knownor suspected neuroblastoma were evaluated for evi dence of skeletal and extraskeletal disease. In 77 of 77 patients with confirmedneuroblastoma,the MDPand MIBG scans were concordant for the presence or absence of skel etal disease. A nearly twofold greater number of skeletal lesions were evident on MIBG scanning. No patients with normalbone scans had MIBG studies indicatingbone involve ment. In patients with histologicevidence of bone marrow involvement, each study suggestedskeletallesionsin ap proximately 70%. In patients with extraskeletal disease dem onstrated by CT, there was soft-tissue uptake of MIBG in 80% andMDPin 39%. We conclude thatbothMIBGand MDP are usefulfor the detectionof skeletalneuroblastoma. MIBG is the better agent for characterizing the extent of disease, and MDPis a valuableadjunctiveagent that provides skeletal landmarksfor comparison. MIBGis clearly superior for the detection of extraskeletal neuroblastoma.