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Journal of Postgraduate Medicine
Medknow Publications and Staff Society of Seth GS Medical College and KEM Hospital, Mumbai, India
ISSN: 0022-3859 EISSN: 0022-3859
Vol. 50, No. 4, 2004, pp. 257-261
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Bioline Code: jp04088
Full paper language: English
Document type: Research Article
Document available free of charge
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Journal of Postgraduate Medicine, Vol. 50, No. 4, 2004, pp. 257-261
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Does I-131-MIBG underestimate skeletal disease burden in neuroblastoma?
Barai Sukanta, Bandopadhayaya GP, Malhotra A, Agarwal S, Kumar R, Dhanapathi H
Abstract
Background:
Controversy persists as to the need for both MIBG and bone scanning in routine evaluation of neuroblastoma.
Aim:
To compare the efficacy of I-131- metaiodobenzylguanidine (MIBG) scan against that of conventional Tc99m- methylene diphosphonate (MDP) bone scan for the detection of skeletal deposition of neuroblastoma.
Methods and Material:
The study included 57 patients (36 boys, 21 girls: age range 1-14 years) of neuroblastoma who underwent both bone scan with Tc99m-MDP and I-131-MIBG scan within 15 days of each other at presentation and during follow-up.
Results:
At presentation 11(19.2%) patients had evidence of skeletal metastases on MDP scan against 7 patients who showed bony secondaries on MIBG scan. Of the 7 patients, with positive MIBG and MDP scans, MDP scan detected 11 sites whereas MIBG scan detected 7 sites. On follow-up study, 3 patients with initial abnormal MDP scan but normal MIBG scan, developed skeletal metastases detectable on MIBG scan, whereas 3 of the 46 patients who had normal MDP and MIBG scan at presentation; developed skeletal metastases detectable on MDP scan. MIBG scan was concordant in 2 of them but was normal in the third patient.
Conclusion:
I-131-MIBG underestimates skeletal disease burden in neuroblastoma. Therefore, Tc99m-MDP bone scan should remain a part of routine assessment of patients with neuroblastoma.
Keywords
Neuroblastoma, Tc99m-MDP bone scan, I-131-MIBG, Metastases.
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