Conventional Nuclear Medicine in Pediatrics by Maria Carmen Garganese & Giovanni Francesco Livio D'Errico

Author:Maria Carmen Garganese & Giovanni Francesco Livio D'Errico
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Genomic profile shows the absence of numerical chromosomal aberration; so, the case is defined as L2 neuroblastoma <12 months of age at diagnosis with IDRFs – NCA genomic profile without life-threatening symptoms. Patient is enrolled in LINES protocol – Group 1 and randomized to receive chemotherapy.

13.2.5 Case 13.5: MIBG Scintigraphy in MS Neuroblastoma

A 2-month-old baby refers to our institution for vomiting and lack of appetite; an ultrasonography shows a left adrenal lesion that compresses left kidney and multiple hyperechoic areas in the liver, respectively. CT confirms ultrasonographic findings (Fig. 13.5a–f).

Fig. 13.5(a–f) Contrast-enhanced CT. Transverse (a), MPR coronal (b), and sagittal (c) images show a mass in left adrenal lodge (with diameters about 41 × 35 × 38 mm); tumor appears round-shaped and well-circumscribed; it displaces and compresses left kidney, separated from the tumor by a fatty layer. The mass has a wide contact with aorta, celiac artery, and splenic vessels, stretched and flattened; a part of the left vein is completely encased by the tumor. CT scan shows also multiple peripherally enhancing lesions throughout the liver, consistent with the metastases (transverse images, d–f). (g, h) MIBG scintigraphy (static views, g) detects a large area of intense and nonhomogeneous radiotracer uptake in abdomen, in left paravertebral region; SPECT-CT fused images (h) confirm that the area of uptake corresponds to the adrenal lesion detected by CT; the liver shows nonhomogeneous radiotracer uptake, due to multiple secondary nodules evident at CT (g, h); no other areas of pathological uptake of radiotracer are evident

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