Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Semin Nucl Med. 2023 Jul;53(4):517-529. doi: 10.1053/j.semnuclmed.2022.12.004. Epub 2023 Jan 21.
Neuroblastoma is the most common extracranial solid tumor in children and arises from anywhere along the sympathetic nervous system. It is a highly heterogeneous disease with a wide range of prognosis, from spontaneous regression or maturing to highly aggressive. About half of pediatric neuroblastoma patients develop the metastatic disease at diagnosis, which carries a poor prognosis. Nuclear medicine plays a pivotal role in the diagnosis, staging, response assessment, and long-term follow-up of neuroblastoma. And it has also played a prominent role in the treatment of neuroblastoma. Because the structure of metaiodobenzylguanidine (MIBG) is similar to that of norepinephrine, 90% of neuroblastomas are MIBG-avid. I-MIBG whole-body scintigraphy is the standard nuclear imaging technique for neuroblastoma, usually in combination with SPECT/CT. However, approximately 10% of neuroblastomas are MIBG nonavid. PET imaging has many technical advantages over SPECT imaging, such as higher spatial and temporal resolution, higher sensitivity, superior quantitative capability, and whole-body tomographic imaging. In recent years, various tracers have been used for imaging neuroblastoma with PET. The importance of patient-specific targeted radionuclide therapy for neuroblastoma therapy has also increased. I-MIBG therapy is part of the front-line treatment for children with high-risk neuroblastoma. And peptide receptor radionuclide therapy with radionuclide-labeled somatostatin analogues has been successfully used in the therapy of neuroblastoma. Moreover, radioimmunoimaging has important applications in the diagnosis of neuroblastoma, and radioimmunotherapy may provide a novel treatment modality against neuroblastoma. This review discusses the use of current and novel radiopharmaceuticals in nuclear medicine imaging and therapy of neuroblastoma.
神经母细胞瘤是儿童最常见的颅外实体瘤，起源于交感神经系统的任何部位。它是一种高度异质性的疾病，预后差异很大，从自发消退或成熟到高度侵袭性不等。约一半的小儿神经母细胞瘤患者在诊断时即发生转移性疾病，预后不良。核医学在神经母细胞瘤的诊断、分期、疗效评估和长期随访中发挥着关键作用。它在神经母细胞瘤的治疗中也发挥了重要作用。由于间碘苄胍（MIBG）的结构与去甲肾上腺素相似，90%的神经母细胞瘤对 MIBG 具有亲合力。I-MIBG 全身闪烁显像术是神经母细胞瘤的标准核医学成像技术，通常与 SPECT/CT 联合使用。然而，约 10%的神经母细胞瘤对 MIBG 无亲合力。与 SPECT 成像相比，PET 成像具有许多技术优势，如更高的空间和时间分辨率、更高的灵敏度、更好的定量能力以及全身断层成像。近年来，各种示踪剂已被用于 PET 成像以诊断神经母细胞瘤。针对神经母细胞瘤的患者特异性靶向放射性核素治疗的重要性也有所增加。I-MIBG 治疗是高危神经母细胞瘤患儿一线治疗的一部分。放射性核素标记的生长抑素类似物的肽受体放射性核素治疗已成功应用于神经母细胞瘤的治疗。此外，放射免疫成像在神经母细胞瘤的诊断中有重要应用，放射免疫治疗可能为神经母细胞瘤提供一种新的治疗方式。本文综述了当前和新型放射性药物在神经母细胞瘤核医学成像和治疗中的应用。
