Key result
Postoperative muscle hypertrophy may cause transient false-positive 123I-MIBG in neuroblastoma.
Case Report (n=1)
Skeletal muscle hypertrophy following asymmetric surgery can cause transient, false-positive 123I-MIBG uptake that must be considered in differential diagnosis.
Transient muscle hypertrophy may mimic recurrence on 123I-MIBG; leaves open specificity of post-surgical surveillance imaging.
A 5-year-old girl with high-risk neuroblastoma underwent 123I-MIBG SPECT/CT after resection of a right adrenal tumor. Baseline 123I-MIBG imaging showed no abnormal uptake. At 6 months, focal 123I-MIBG accumulation appeared in the left erector spinae muscle, correlating with hypertrophy on CT. By 12 months, uptake had fully resolved, although muscular hypertrophy partially regressed. This illustrates that skeletal muscle hypertrophy, especially post-asymmetric surgery, can cause transient, false-positive 123I-MIBG uptake an must be considered in the differential diagnosis of unexpected tracer accumulation.
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Zhang et al. (2026) conducted a case report in High-risk neuroblastoma (n=1). Contralateral erector spinae muscle hypertrophy following retroperitoneal surgery was evaluated on False-positive 123I-MIBG uptake. Skeletal muscle hypertrophy following asymmetric retroperitoneal surgery can cause transient, false-positive 123I-MIBG uptake in a child with neuroblastoma.
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