[124I]mIBG

Metaiodobenzylguanidine (MIBG) is an analog of norepinephrine that accumulates in sympathetic nerve endings soon after intravenous administration. The degree of accumulation reflects the uptake, storage and release of transmitters by noradrenergic neurons. Myocardial imaging with ¹²³I labeled MIBG ( ¹²³I-MIBG) can be used to estimate the extent of local myocardial sympathetic nerve damage, which has been widely used in the diagnosis and treatment of various heart diseases. In recent years, numerous studies have been carried out on the application of ¹²³I-MIBG in the diagnosis of degenerative diseases of the nervous system (such as Parkinson's disease and dementia of Lewy body), and have made some achievements. The purpose of this review is to summarize the current clinical application of ¹²³I-MIBG myocardial imaging in the diagnosis of dementia with Lewy bodies, the problems in imaging technology and the possible research directions in the future, so as to provide valuable reference information for clinicians to reasonably and accurately apply this technology in the early diagnosis and discrimination of dementia.

Neuroblastoma is the most common extracranial malignant solid tumor during childhood. Despite intensified treatment, patients with high‐risk neuroblastoma (HR‐NBL) still carry a dismal prognosis. The Thai Pediatric Oncology Group (ThaiPOG) proposed the use of a multimodality treatment to improve outcomes of HR‐NBL in non‐immunotherapy settings.

Patients with HR‐NBL undergoing ThaiPOG protocols (ThaiPOG‐NB‐13HR or ‐18HR) between 2013 and 2019 were retrospectively reviewed. Patient demographic data, treatment modalities, outcomes, and prognostic factors were evaluated and analyzed.

A total of 183 patients with HR‐NBL undergoing a topotecan containing induction regimen were enrolled in this study. During the consolidation phase (n = 169), 116 patients (68.6%) received conventional chemotherapy, while 53 patients (31.4%) underwent hematopoietic stem cell transplantation (HSCT). The 5‐year overall survival (OS) and event‐free survival (EFS) were 41.2% and 22.8%, respectively. Patients who underwent HSCT had more superior 5‐year EFS (36%) than those who received chemotherapy (17.1%) (p = .041), although they both performed similarly in 5‐year OS (48.7% vs. 39.8%, p = .17). The variation of survival outcomes was observed depending on the number of treatment modalities. HSCT combined with metaiodobenzylguanidine (MIBG) treatment and maintenance with 13‐cis‐retinoic acid (cis‐RA) demonstrated a desirable 5‐year OS and EFS of 65.6% and 58.3%, respectively. Poorly or undifferentiated tumor histology and cis‐RA administration were independent factors associated with relapse and survival outcomes, respectively (p < .05).

A combination of HSCT and cis‐RA successfully improved the outcomes of patients with HR‐NBL in immunotherapy inaccessible settings.