Functional-metabolic imaging of neuroblastoma

Neuroblastoma is the third most common malignant solid tumor of childhood. It originates from primitive neural crest cells of the sympathetic nervous system. Many imaging procedures help guide therapy and predict outcomes. Anatomic imaging methods, such as CT and MRI, are most useful for evaluation of the primary tumor mass and nearby involved lymph nodes. Functional imaging tracers, such as [123I]MIBG, [18F]FDG, and [99mTc]MDP, are used to assess the extent of disease and to search for distant metastases. [123I]MIBG is the principal functional imaging tracer for the detection and monitoring of neuroblastoma. [18F]FDG PET/CT is an alternative that is valuable in tumors with poor or no MIBG-uptake. [99mTc]MDP bone scans may be useful to assess cortical bone metastases. This article will review the use of [123I]MIBG and other functional imaging agents for the management of patients with neuroblastoma.