RESTON, Va. - A new study published in the August issue of The Journal of Nuclear Medicine shows that positron emission tomography (PET) is an important tool for depicting the extent of neuroblastoma in some patients, particularly for those in the early stages of the disease. Neuroblastoma accounts for six to ten percent of all childhood cancers in the United States and 15 percent of cancer deaths in children. Accurately identifying where in the body the disease is located and whether it is spreading is critical for choosing appropriate types of treatment, which can include surgery, chemotherapy, radiation and-in the most advanced cases-a combination of all of these treatments along with bone marrow transplant or investigational therapies.

In recent years, 123I-metaiodobenzylguanidine (MIBG) has been the main functional imaging agent used to assess the disease. Fluorodeoxyglucose (FDG) PET imaging of neuroblastoma is increasing, but questions remain regarding when and in which patients FDG PET imaging is most useful.

"Functional imaging plays an important role in assessing neuroblastoma, from initially diagnosing and staging the disease to determining whether patients are responding to treatment or whether the disease has recurred," said Susan E. Sharp, M.D., assistant professor of clinical radiology at Cincinnati Children's Hospital Medical Center and lead author of the study. "Our study found that while MIBG remains the front-line imaging tool for neuroblastoma, FDG-PET imaging can benefit some patients, especially those with early-stage disease."
The study also found that FDG PET may also be useful in imaging neuroblastoma tumors that do not readily absorb MIBG. In these cases, imaging with MIBG alone may not reveal some malignant lesions in the body.

Neuroblastoma-a form of cancer that starts in certain types of very primitive developing nerve cells found in an embryo or fetus-occurs most frequently in infants and young children. There are about 650 new cases of the cancer reported in the U.S. each year, according to the National Cancer Institute. The cancer most often originates on the adrenal glands-the triangular-shaped glands above the kidneys. Neuroblastoma often spreads to other parts of the body before any symptoms are apparent.

Patients with the disease are classified as low-, medium- or high-risk based on a combination of clinical staging of the disease and certain biologic and genetic characteristics, such as the age of the patient, extent of disease spread, microscopic appearance and genetic factors.

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