Utility of follow-up studies using meta-[123 I]iodobenzylguanidine scintigraphy for detecting recurrent neuroblastoma

Neuroblastomas sometimes recur after the initial disappearance of the tumour. We evaluated the utility of meta-[123I]iodobenzylguanidine (123I-MIBG) scintigraphy for the detection of recurrent neuroblastomas by comparing with the measurement of biochemical markers and clinical findings. Forty patients who had received treatment for neuroblastomas were included in the study. After the disappearance of the initial tumours, periodic measurements of urinary vanillyl mandelic acid, homovanillic acid and serum neuron specific enolase values, and an 123I-MIBG scintigraphy were performed. Whenever an abnormal finding was observed, other appropriate examinations and/or follow-up examinations were performed to elucidate the true state of the patient. Eleven recurrent episodes in eight patients were observed. Most of them occurred in the bone marrow or bone. Corresponding symptoms were observed in only two episodes; the other episodes were asymptomatic, and discovered by the periodic examinations. 123I-MIBG scintigrams visualized the recurrent tumours in 10 (91%) episodes. Elevated tumour markers were observed in only three episodes. 123I-MIBG scintigrams visualized most of the recurrent tumours, unless they were accompanied by any symptoms or elevations in biochemical tumour markers. Periodic examinations with 123I-MIBG scintigraphy appears to be a useful technique for the detection of the recurrences.