The value of single-photon emission computed tomography combined with computed tomography imaging in ¹²³I-Metaiodobenzylguanidine scintigraphy in children with neuroblastoma

The value of single-photon emission computed tomography combined with computed tomography imaging in ¹²³I-Metaiodobenzylguanidine scintigraphy in children with neuroblastoma

Whole body scintigraphy with ¹²³I-Metaiodobenzylguanidine (¹²³I-MIBG) is an important imaging modality for evaluation of patients with neuroblastoma (NB). As the intrinsic nuclear scintigraphic characteristics, the assessment of conventional planar ¹²³I-MIBG images presents some difficulties. The limited resolution of planar images can induce false-negative results for small lesions, whereas the presence of physiologic MIBG uptake is not always easily differentiable from pathologic uptake and can induce false-positive results. Single-photon emission computed tomography combined with computed tomography (SPECT/ CT) hybrid imaging technique, allowing the direct fusion of morphologic and functional information, has been suggested to be more accurate. However, SPECT/CT imaging renders slightly more radiation to patients from CT portion of the study and is time consuming. The aim of our study was to investigate how much SPECT/CT can have additional diagnostic value over planar imaging in NB patients at initial staging. The study was approved by the Independent Ethics Committee and the Scientific Council of the D. Rogachev NMRCPHOI. A total of 251 SPECT/CT scans following by planar ¹²³I-MIBG imaging scans performed in 251 patients with NB were retrospectively analyzed. In 72.1% of the studies, the whole-body planar images and SPECT/CT images showed the same result. In 27.9% of studies, however, SPECT/CT images provided additional very important information. In our study, the diagnosis reached by planar imaging was revised or specified by SPECT/CT in 70 of the 251 patients and was clinically significant.