Combined In-111-pentetreotide scintigraphy and I-123-mIBG scintigraphy in neuroblastoma provides prognostic information

Background. High-affinity somatostatin receptors (SRs) have been characteri zed in neuroblastomas and may be used as target structures for in vivo dete ction of SR. Procedure. Eighty-eight children with histologically proven ne uroblastoma were investigated at diagnosis or relapse by I-123-mIBG and In- 111-pentetreotide scintigraphy. Ail tumors were investigated for MYCN copy number, chromosome 1p36 status, and 68/88 also for DNA content, followed fo r a median follow-up of 35 months (range 1-88 months). Results. SR expressi on was detected in 56/88 tumors and I-123-mIBG showed positivity in 83/88. In-111-pentetreotide was less sensitive in detecting tumor tissue than was I-123-mIBG (64% vs. 94%, P = 0.005). Survival (SUR) and event-free survival probability (EFS) according to Kaplan-Meier was significantly better for c hildren with positive SR scintigraphy than for the children with a negative SR scan (SUR: 90% vs. 48% at 4 years log rank P < 0.003, EFS: 83% vs. 39% at 4 years, log rank P < 0.0002). Conclusions. I-123-mIBG scintigraphy rema ins the best scintigraphic method for detecting neuroblastoma tumor tissue, whereas additional SR scintigraphy is able to provide significant prognost ic information with a minimum of invasiveness. (C) 2000 Wiley-Liss. Inc.