The Pediatric Neuroblastoma: Application of MIBG Scintigraphy in Diagnosis, Staging, and Follow-up – Analysis of Three Cases

Introduction: Neuroblastoma is the most common extracranial solid tumor in children, accounting for 8-10% of all pediatric cancers. Accurate diagnosis and management rely on imaging modalities and biological markers such as elevated urinary catecholamines. Among the various imaging techniques, Metaiodobenzylguanidine (MIBG) scintigraphy, often combined with SPECT/CT, provides high specificity for neuroblastoma cells. It is crucial for determining tumor extent, identifying metastatic disease, and monitoring therapeutic response. Materials and Methods: This study presents three clinical cases illustrating the role of MIBG scintigraphy in the diagnosis, staging, and follow-up of pediatric neuroblastoma. The three patients underwent Iodine-131 labeled MIBG scintigraphy, with planar imaging, and in two cases, additional SPECT/CT imaging. Results : Case 1: A 3-year-old child with a right adrenal mass and diffuse bone marrow metastases, classified as stage IV neuroblastoma. Case 2: An 11-year-old girl with recurrent retroperitoneal neuroblastoma identified during follow-up MIBG scintigraphy. Case 3: An 11-year-old girl with no evidence of disease progression, confirmed by MIBG scintigraphy, indicating complete remission. Conclusion: MIBG scintigraphy is an invaluable tool in the management of neuroblastoma, offering precise tumor localization, accurate staging, and effective monitoring of treatment response. Its integration into clinical practice helps guide therapeutic decisions and improves patient outcomes.