18F-mFBG PET Detects Neuroblastoma Recurrence Prior to 123I-mIBG SPECT

Background: A high-risk stage M neuroblastoma patient suspected of residual disease in a T3-4 paraspinal soft tissue mass had no evidence of disease on MRI or 123 I- m IBG SPECT/CT. Observations: 18 F- m FBG PET/CT performed in a clinical trial showed abnormalities in the upper and lower thoracic spine, lumbar spine, and pelvis. Two months later, the MRI was unchanged, and 123 I- m IBG SPECT/CT showed only an equivocal upper thoracic spine focus. 123 I- m IBG SPECT/CT and MRI at 4 months post- 18 F- m FBG showed positive findings in the thoracic spine consistent with neuroblastoma. Conclusions: Follow-up confirmed that 18 F- m FBG PET/CT identified neuroblastoma at least 2 months prior to 123 I- m IBG and MRI.