Diagnostic Use of Post-therapy I-Meta-Iodobenzylguanidine Scintigraphy in Consolidation Therapy for Children with High-Risk Neuroblastoma.

I-meta-iodobenzylguanidine (I-mIBG) scintigraphy is used for evaluating disease extent in children with neuroblastoma. I-mIBG therapy has been used for evaluation in children with high-risk neuroblastoma, and post-therapy I-mIBG scintigraphy may detect more lesions compared with diagnostic I-mIBG scintigraphy. However, no studies have yet revealed the detection rate of hidden mIBG-avid lesions on post-therapy I-mIBG whole-body scan (WBS) and SPECT images in neuroblastoma children without mIBG-avid lesions as demonstrated by diagnostic I-mIBG scintigraphy. We retrospectively examined the diagnostic utility of post-therapy I-mIBG scintigraphy in children who received I-mIBG as consolidation therapy. Nineteen children with complete response to primary therapy were examined. Post-therapy I-mIBG scintigraphy was performed four days after injection. The post-therapy I-mIBG scintigraphy, 4 children exhibited abnormal uptake on the WBS. Post-therapy I-mIBG SPECT/CT provided additional information in 2 cases. In total, 6 children exhibited abnormal uptake. The site of abnormal accumulation was on the recurrence site in one case, operation sites in five cases, and bone metastasis in one case. Post-therapy I-mIBG scintigraphy could detect residual disease that was not recognized using diagnostic I-mIBG scintigraphy in 32% of children with high-risk neuroblastoma and ganglioneuroblastoma. The diagnostic use of post-therapy I-mIBG scintigraphy can provide valuable information for detecting residual disease.