Barai, SBandopadhayaya, G PMalhotra, AAgarwal, SKumar, RDhanapathi, H2004-10-302009-06-022004-10-302009-06-022004-10-30Barai S, Bandopadhayaya GP, Malhotra A, Agarwal S, Kumar R, Dhanapathi H. Does I-131-MIBG underestimate skeletal disease burden in neuroblastoma? Journal of Postgraduate Medicine. 2004 Oct-Dec; 50(4): 257-60; discussion 260-1http://imsear.searo.who.int/handle/123456789/115362BACKGROUND: Controversy persists as to the need for both MIBG and bone scanning in routine evaluation of neuroblastoma. AIM: To compare the efficacy of I-131- metaiodobenzylguanidine (MIBG) scan against that of conventional Tc99m- methylene diphosphonate (MDP) bone scan for the detection of skeletal deposition of neuroblastoma. METHODS AND MATERIAL: The study included 57 patients (36 boys, 21 girls: age range 1-14 years) of neuroblastoma who underwent both bone scan with Tc99m-MDP and I-131-MIBG scan within 15 days of each other at presentation and during follow-up. RESULTS: At presentation 11(19.2%) patients had evidence of skeletal metastases on MDP scan against 7 patients who showed bony secondaries on MIBG scan. Of the 7 patients, with positive MIBG and MDP scans, MDP scan detected 11 sites whereas MIBG scan detected 7 sites. On follow-up study, 3 patients with initial abnormal MDP scan but normal MIBG scan, developed skeletal metastases detectable on MIBG scan, whereas 3 of the 46 patients who had normal MDP and MIBG scan at presentation; developed skeletal metastases detectable on MDP scan. MIBG scan was concordant in 2 of them but was normal in the third patient. CONCLUSION: I-131-MIBG underestimates skeletal disease burden in neuroblastoma. Therefore, Tc99m-MDP bone scan should remain a part of routine assessment of patients with neuroblastoma.eng3-Iodobenzylguanidine --diagnostic useAdolescentBone Neoplasms --radionuclide imagingChildChild, PreschoolFemaleHumansInfantMaleNeuroblastoma --radionuclide imagingProspective StudiesRadiopharmaceuticals --diagnostic useTechnetium Tc 99m Medronate --diagnostic useComparative Study