1. 124I-MIBG PET/CT to Monitor Metastatic Disease in Children with Relapsed Neuroblastoma
- Author
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Aboian, Mariam S, Huang, Shih-Ying, Hernandez-Pampaloni, Miguel, Hawkins, Randall A, VanBrocklin, Henry F, Huh, Yoonsuk, Vo, Kieuhoa T, Gustafson, W Clay, Matthay, Katherine K, and Seo, Youngho
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Oncology and Carcinogenesis ,Cancer ,Pediatric ,Rare Diseases ,Bioengineering ,Neurosciences ,Biomedical Imaging ,Clinical Research ,4.2 Evaluation of markers and technologies ,4.1 Discovery and preclinical testing of markers and technologies ,3-Iodobenzylguanidine ,Child ,Preschool ,Female ,Humans ,Iodine Radioisotopes ,Male ,Neoplasm Metastasis ,Neuroblastoma ,Positron Emission Tomography Computed Tomography ,Recurrence ,Single Photon Emission Computed Tomography Computed Tomography ,neuroblastoma ,I-124 ,I-124-MIBG ,metaiodobenzylguanidine ,PET/CT ,124I ,124I-MIBG ,Nuclear Medicine & Medical Imaging ,Clinical sciences - Abstract
The metaiodobenzylguanidine (MIBG) scan is one of the most sensitive noninvasive lesion detection modalities for neuroblastoma. Unlike 123I-MIBG, 124I-MIBG allows high-resolution PET. We evaluated 124I-MIBG PET/CT for its diagnostic performance as directly compared with paired 123I-MIBG scans. Methods: Before 131I-MIBG therapy, standard 123I-MIBG imaging (5.2 MBq/kg) was performed on 7 patients, including whole-body (anterior-posterior) planar imaging, focused-field-of-view SPECT/CT, and whole-body 124I-MIBG PET/CT (1.05 MBq/kg). After therapy, 2 of 7 patients also completed 124I-MIBG PET/CT as well as paired 123I-MIBG planar imaging and SPECT/CT. One patient underwent 124I-MIBG PET/CT only after therapy. We evaluated all 8 patients who showed at least 1 123I-MIBG-positive lesion with a total of 10 scans. In 8 pairs, 123I-MIBG and 124I-MIBG were performed within 1 mo of each other. The locations of identified lesions, the number of total lesions, and the curie scores were recorded for the 123I-MIBG and 124I-MIBG scans. Finally, for 5 patients who completed at least 3 PET/CT scans after administration of 124I-MIBG, we estimated the effective dose of 124I-MIBG. Results:123I-MIBG whole-body planar scans, focused-field-of-view SPECT/CT scans, and whole-body 124I-MIBG PET scans found 25, 32, and 87 total lesions, respectively. There was a statistically significant difference in lesion detection for 124I-MIBG PET/CT versus 123I-MIBG planar imaging (P < 0.0001) and 123I-MIBG SPECT/CT (P < 0.0001). The curie scores were also higher for 124I-MIBG PET/CT than for 123I-MIBG planar imaging and SPECT/CT in 6 of 10 patients. 124I-MIBG PET/CT demonstrated better detection of lesions throughout the body, including the chest, spine, head and neck, and extremities. The effective dose estimated for patient-specific 124I-MIBG was approximately 10 times that of 123I-MIBG; however, given that we administered a very low activity of 124I-MIBG (1.05 MBq/kg), the effective dose was only approximately twice that of 123I-MIBG despite the large difference in half-lives (100 vs. 13.2 h). Conclusion: The first-in-humans use of low-dose 124I-MIBG PET for monitoring disease burden demonstrated tumor detection capability superior to that of 123I-MIBG planar imaging and SPECT/CT.
- Published
- 2021