Boubaker A, Bischof Delaloye A
Service of Nuclear Medicine, Vaudois University Hospital Center, Lausanne, Switzerland.
Q J Nucl Med Mol Imaging. 2008 Dec;52(4):388-402.
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.
神经母细胞瘤（NBL）是儿童最常见的颅外实体瘤，也是1至4岁儿童癌症相关死亡的主要原因。NBL的表现形式差异很大，从侵袭性较小的4S期NBL或先天性形式（高达90%的儿童可能无需治疗即可自愈），到年龄较大儿童中高危播散性4期疾病（治愈率为35%至40%）。初始分期对于有效治疗至关重要，用碘-123标记的间碘苄胍（MIBG）是一种强大的工具，对NBL诊断的敏感性约为90%，特异性接近100%。MIBG闪烁扫描术在临床上常规使用，并且在大多数研究性临床试验中都是必需的，用于疾病的初始分期、评估治疗反应以及在随访期间检测复发情况。关于播散性4期NBL患儿的预后，几个研究小组已经对治疗后[（123）I]MIBG扫描的作用进行了研究，但到目前为止尚未达成共识，不过MIBG评估的完全缓解或非常好的部分缓解可能具有预后价值。NBL在诊断和随访期间需要多模式方法，MIBG闪烁扫描术保持其关键作用，特别是在骨髓受累和/或皮质骨转移方面。
