L. Manil et al., INDIUM-111-PENTETREOTIDE SCINTIGRAPHY IN CHILDREN WITH NEUROBLAST-DERIVED TUMORS, The Journal of nuclear medicine, 37(6), 1996, pp. 893-896
The somatostatin analog (111)ln-pentetreotide was evaluated in 11 chil
dren with sympathetic embryonic cell-derived tumors. Methods: Six neur
oblastomas, four ganglioneuroblastomas and one ganglioneuroma (benign)
were imaged 4 and 24 hr after injection of (111)ln-pentetreotide (5 M
Bq/kg) and 24 hr after administration of (123)-metaiodobenzylguanidine
(MIBG) (3.7 MBq/kg). Results: Primary tumor was detected with both tr
acers in four of the five patients studied before surgery (one Stage I
II neuroblastoma, one Stage IV neuroblastoma, one Stage IVs neuroblast
oma, one ganglioneuroblastoma), but the ganglioneuroma was not localiz
ed. Detection of bone marrow metastases was clearly better with (111)l
n-pentetreotide in two patients, similar or slightly better with MIBG
in six and (true) negative with both procedures in three. The positivi
ty rate of (111)ln-pentetreotide for imaging of metastases was higher
in undifferentiated malignant tumors (six neuroblastomas: two very pos
itive, three positive, one true-negative) than in histologically well-
differentiated tumors (four ganglioneuroblastomas: three weakly positi
ve, one true-negative). All patients with positive (111)ln-pentetreoti
de imaging results had elevated urinary catecholamine levels, and the
two most (111)ln-pentetreotide-positive metastases were found in neuro
blastomas from children with an aneuploid primary tumor. The (111)ln-p
entetreotide and MIBG results were only partly correlated with bone ma
rrow status, as assessed by immunocytological and histological studies
at the time of scanning. Conclusion: Abnormalities detected in (111)l
n-pentetreotide uptake were slightly different from those seen with MI
BG, but (111)ln-pentetreotide is unlikely to replace MIBG as a first-l
ine routine method in neuroblast-derived tumors. However, some MIBG-ne
gative tumor sites were detected by (111)ln-pentetreotide in patients
with neuroblastomas. Thus, (111)ln-pentetreotide could provide novel i
nformation on the biology and prognosis of tumors whose clinical signi
ficance remains to be defined.