MIBG Scan for Neuroblastoma Staging

B. MIBG staging of neuroblastoma determines extent of disease (number and distribution of metastases), guides risk stratification, and identifies patients who are candidates for I-131 MIBG targeted therapy

MIBG scintigraphy is fundamental in neuroblastoma management: (1) STAGING — approximately 90% of neuroblastomas are MIBG-avid; whole-body MIBG scan demonstrates extent of metastatic disease (bone, bone marrow, liver, lymph nodes) better than CT alone; (2) RISK STRATIFICATION — extent of MIBG disease is incorporated into INRG risk grouping (international neuroblastoma staging); (3) THERAPY SELECTION — MIBG-avid tumors qualify for I-131 MIBG targeted radionuclide therapy (Azedra), which delivers concentrated radiation to tumor sites; (4) RESPONSE ASSESSMENT — MIBG score changes after therapy reflect treatment response. Ga-68 DOTATATE PET/CT is complementary but MIBG remains central to neuroblastoma management.