19 patients with histologically verified neuroblastoma (n = 18) or suspected of suffering from neuroblastoma (n = 1) were investigated 35 times using 123I- or 131I-labelled meta-iodobenzylguanidine (MIBG) scintigraphy. The purpose of this investigation was to evaluate the accuracy of MIBG imaging in comparison to other diagnostic procedures. X-ray or sonographical procedures depicted 40 neuroblastoma manifestations (primary tumours and metastatic deposits), 36 of these (90%) were found by MIBG scintigraphy. Out of 63 primary neuroblastomas and metastatic deposits, depicted by MIBG scintigraphy, 40 (63%) were detected by corresponding sonographic or x-ray procedures. The 23 neuroblastoma lesions solely depicted by MIBG scans were mainly (87%) situated in the skeletal system. In 12 patients biopsy of the bone marrow confirmed the scintigraphic findings (9 times true positive, 3 times true negative). Three times bone marrow infiltration was not recognized by MIBG scintigraphy. False positive results were not observed. 13 patients were examined before and after chemotherapy; scintigraphic results corresponded to therapy results. Because of the pronounced physiological MIBG uptake by liver tissue, detection of intrahepatic or perihepatic tumour involvement may be difficult. MIBG imaging seems not to be suitable for detecting minimal bone marrow infiltration by neuroblastoma. It is a safe and noninvasive procedure for locating a wide range of neuroblastoma lesions. Its main diagnostic advantage in comparison to x-ray procedures lies in the detection of bone marrow infiltration.
