I-131 MIBG MYOCARDIAL UPTAKE IN LOCALLY ADVANCED AND METASTATIC NEUROBLASTOMA PATIENTS: DOES IT CARRY A PROGNOSTIC SIGNIFICANCE?
Abstract
Introduction: Neuroblastoma is the most common solid extra cranial malignancy in children younger than 15 years. Though there are many prognostic factors for neuroblastoma, none of them is considered to provide enough additional value to be used in clinical practice. Radio-iodinated Metaiodobenzylguanidine (MIBG) is a functioning analog of norepinephrine taken up by sympathetic neurons and considered very good radiopharmaceutical for diagnosis of neuroblastoma .
Aim of the work : In this work, we are looking for a possibly relevant correlation between myocardial I-131 MIBG extent of uptake and outcome in neuroblastoma to be further used as a prognostic value.
Patients: This study included 38 pediatric patients with pathologically proven stage III & IV neuroblastoma. Twenty one of the study patients (53.85%) were males and 18 (46.15%) were females with a ratio of 1.17 to 1.0 respectively. Their age ranged from 6 months to 12 years, with a mean of 4.8±3.3 years. All patients were treated with neoadjuvant chemotherapy according to protocols issued at the Pediatric Oncology Department, NCI (OPEC, OJEC ICE, CADO). Assessment of response to combined modality treatment was defined in terms of complete response "CR", very good partial response "VPR", partial response "PR", stable disease "SD", or progressive disease "PD". Objective response (OR) is the sum of complete plus any partial response. I-131 MIBG scan was done 24 and 48 hours after IV injection of 0.5-1 mCi I-131 MIBG 5 days prior to starting chemo-therapy. Myocardial I-131 MIBG uptake in the anterior image of the whole body was graded according to the following scale: grade (0): no visible uptake, grade (1): mild uptake, grade (2):moderate uptake, grade (3): prominent uptake.
Results: We found statistically significant correlation between I-131 MIBG myocardial uptake and patients outcome with P value
Aim of the work : In this work, we are looking for a possibly relevant correlation between myocardial I-131 MIBG extent of uptake and outcome in neuroblastoma to be further used as a prognostic value.
Patients: This study included 38 pediatric patients with pathologically proven stage III & IV neuroblastoma. Twenty one of the study patients (53.85%) were males and 18 (46.15%) were females with a ratio of 1.17 to 1.0 respectively. Their age ranged from 6 months to 12 years, with a mean of 4.8±3.3 years. All patients were treated with neoadjuvant chemotherapy according to protocols issued at the Pediatric Oncology Department, NCI (OPEC, OJEC ICE, CADO). Assessment of response to combined modality treatment was defined in terms of complete response "CR", very good partial response "VPR", partial response "PR", stable disease "SD", or progressive disease "PD". Objective response (OR) is the sum of complete plus any partial response. I-131 MIBG scan was done 24 and 48 hours after IV injection of 0.5-1 mCi I-131 MIBG 5 days prior to starting chemo-therapy. Myocardial I-131 MIBG uptake in the anterior image of the whole body was graded according to the following scale: grade (0): no visible uptake, grade (1): mild uptake, grade (2):moderate uptake, grade (3): prominent uptake.
Results: We found statistically significant correlation between I-131 MIBG myocardial uptake and patients outcome with P value