Comparison of ¹²³I-metaiodobenzylguanidine (MIBG) and ¹³¹I-MIBG semi-quantitative scores in predicting survival in patients with stage 4 neuroblastoma: a report from the Children's Oncology Group

Pediatr Blood Cancer. 2011 Jul 1;56(7):1041-5. doi: 10.1002/pbc.22991. Epub 2011 Feb 15.


Background: ¹²³I-metaiodobenzylguanidine (MIBG) scans are preferable to ¹³¹I-MIBG for neuroblastoma imaging as they deliver less patient radiation yet have greater sensitivity in disease detection. Both ¹²³I-MIBG and ¹³¹I-MIBG scans were used for disease assessments of neuroblastoma patients enrolled on Children's Oncology Group (COG) high-risk study A3973. The hypothesis was that ¹²³I-MIBG and ¹³¹I-MIBG scans were sufficiently similar for clinical purposes in terms of ability to predict survival.

Procedure: Patients enrolled on COG A3973 with stage 4 disease who completed ¹²³I-MIBG or ¹³¹I-MIBG scans at diagnosis, post-induction, post-transplant, or post-biotherapy were analyzed. The performance of the Curie score for each MIBG scan type in predicting survival was evaluated. At each time point, survival curves for ¹²³I-MIBG versus ¹³¹I-MIBG were compared using the log-rank test.

Results: Of the 413 patients on A3973 with at least one MIBG scan, 350 were stage 4. The 5-year event-free survival (EFS) and overall survival (OS) rates were 33.4 ± 3.6% and 45.6 ± 4.0% (N = 350). At post-induction, EFS (P = 0.3501) and OS (P = 0.5337) for ¹²³I-MIBG versus ¹³¹I-MIBG were not significantly different. Similarly, comparisons at the three other time points were non-significant.

Conclusions: We found no evidence of a statistically significant difference in outcome by type of scan. For future survival analyses of MIBG Curie scores, ¹²³I-MIBG and ¹³¹I-MIBG results may be combined and analyzed overall, without adjustment for scan type.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • 3-Iodobenzylguanidine*
  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Child
  • Child, Preschool
  • Cisplatin / administration & dosage
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Doxorubicin / administration & dosage
  • Female
  • Humans
  • Infant
  • Iodine Radioisotopes*
  • Male
  • Neuroblastoma / diagnostic imaging*
  • Neuroblastoma / mortality*
  • Neuroblastoma / therapy
  • Radionuclide Imaging
  • Radiopharmaceuticals*
  • Remission Induction
  • Stem Cell Transplantation
  • Survival Rate
  • Transplantation, Autologous
  • Treatment Outcome
  • Vincristine / administration & dosage
  • Young Adult


  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • 3-Iodobenzylguanidine
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Cisplatin