18F-MFBG PET replacing 123I-MIBG scintigraphy
A same-day PET tracer could replace the two-day, low-resolution MIBG scan children now undergo repeatedly.
Overview
Children with neuroblastoma repeatedly undergo 123I-MIBG scintigraphy, a two-day, low-resolution scan, and this idea proposes replacing it with same-day 18F-MFBG PET. 18F-meta-fluorobenzylguanidine uses the same norepinephrine-transporter biology as MIBG but gains PET resolution and 18F logistics, needs no sedation across two days, and early data show higher lesion detection. The hypothesis is that MFBG PET/CT detects more lesions than MIBG SPECT with equal specificity, and that Curie-type scoring on MFBG predicts outcome at least as well. Prospective paired comparisons are under way at MSK and in COG imaging studies and an NDA is in progress; at an early clinical stage, it sits within the paediatric oncology roadmap alongside the MIBG theranostics and PET records.
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