Who can enter
- Children and young adults with (suspected or proven) neuroblastoma who have been referred for an MIBG scan
- Age: 0-30 years
Goal
The goal of this study is to compare the MFBG scan with the current standard, the MIBG scan, in children and young adults with neuroblastoma. We want to see if this method is equally good at detecting the disease.
Background
Children with neuroblastoma often receive multiple MIBG scans at different times during treatment. These are used to visualize the extent of the disease and assess response to treatment. For these scans, children receive an injection with a mildly radioactive substance called meta-iodobenzylguanidine (MIBG). MIBG is then absorbed by the tumor cells. After 24 hours, the emitted radiation is imaged using a SPECT scanner.
A new scanning technique, the MFBG PET-CT scan, has recently become available and has important advantages over the MIBG scan. The substance meta-fluorobenzylguanidine (MFBG) is very similar to MIBG, only the radioactive iodine has been replaced by radioactive fluorine.
In a pilot study, 20 MFBG PET-CT scans were performed in children with neuroblastoma. Results were promising. MFBG PET-CT scanning was safe and less burdensome for the children. The children did not need to take medication to protect the thyroid gland. The injection and scan took place on the same day, instead of two days. The scan time was much shorter (10 minutes instead of 90 minutes), often eliminating the need for anesthesia. Because of the much sharper images, the MFBG PET-CT scan showed almost all (and often more) disease localizations that were visible on the MIBG scans.
More research is needed before this technique can be used in the clinic. In this study, the MFBG PET-CT scan will be compared with the MIBG scan in a larger group of children. We hope to prove that the MFBG PET-CT scan is indeed as good as the MIBG scan in detecting disease.
Currently, findings on the MIBG scan are used to make clinical decisions. If the MFBG PET-CT scan does indeed find more neuroblastoma locations, this may have implications for the patient, for example, for determining disease stage or treatment. Therefore, we also want to study possible changes in treatment and the prognostic value of the MFBG PET-CT scan.
Children participating in this study will undergo an MFBG PET-CT scan within two weeks of the MIBG scan. This means an additional appointment of about two hours, usually on the same day of the MIBG injection or MIBG scan. For the MFBG PET-CT scan, children receive an additional injection of MFBG via a vein. After about 60 minutes of waiting time, a 10-minute PET-CT scan is made. Patients who consent to a dynamic PET-CT scan will undergo a 70-minute scan (no waiting time) immediately after the injection. The radiation dose of an MFBG PET-CT scan is similar to that of an MIBG scan and is considered negligible. After the first MFBG PET-CT scan, children can undergo two more MFBG PET-CT scans.