PET/CT Imaging Could Transform Diagnosis and Treatment for Children with Neuroblastoma

A new trial has been initiated in the United Kingdom that could change the way children with one of the most lethal types of cancer are diagnosed.

The most aggressive form of neuroblastoma is very difficult to treat. To determine how aggressive the tumor is and find the best possible treatment, physicians currently need to carry out multiple scans employing a variety of techniques, which can be distressing for very young children, especially as it is frequently necessary to carry them out under a general anesthetic. Better scans are urgently needed to diagnose and treat patients with neuroblastoma.

Cancer Research UK’s (London) Center for Drug Development (CDD), in collaboration with the Rising Tide Foundation, a Swiss-based nonprofit organization that funds innovative cancer trials, initiated the new trial at The Royal Marsden (London, UK) and University College London (UK). One of the scans, called a planar scintigraphy scan, involves children being injected with a small amount of a radioactive iodine tracer, called [123I] metaiodobenzylguanidine (mIBG), which is absorbed by the neuroblastoma cells to make them visible on the scan.

In this trial, children will instead be administered a different radioactive iodine tracer called [124I]mIBG, which is chemically identical to [123I]mIBG but emits a different type of radiation that can be captured on a positron emission tomography/computed tomography (PET/CT) scan. This new type of PET/CT scan will give a more accurate three-dimensional image to locate where the neuroblastoma has grown or spread. Physicians can use this data to offer the best treatment options for each patient depending upon how well their cancer has responded to treatment and the risk of it returning. The new [124I]mIBG PET/CT scan will help physicians gauge how well new treatments being tested in clinical trials are working and to choose which patients would most benefit from taking part in these trials. This scan may also remove the need for multiple scans for patients in the future.

Approximately 25 children will take part in the trial at The Royal Marsden NHS Foundation Trust, and University College London Hospital, with radiotracer manufacture being carried out by the Wolfson Molecular Imaging Center (Manchester, UK). If successful the new technique could be offered to children with neuroblastoma across the United Kingdom and abroad.

Study leader Dr. Sue Chua, consultant radiologist and nuclear medicine physician at The Royal Marsden, said, “Offering children a single PET scan instead of multiple scans would take a lot of the stress out of getting neuroblastoma diagnosed, while still providing doctors with the information they need to decide on the best course of treatment. Often the more aggressive form of the disease isn’t picked up until conventional treatments fail, so we also hope this trial will help diagnose the disease earlier so treatment can be adapted accordingly.”

Dr. Nigel Blackburn, director of Cancer Research UK’s Center for Drug Development, said, “Having to perform multiple scans on young children to diagnose their cancer can be distressing for the whole family, so we’re delighted to be funding and managing this trial. Cancer Research UK is funding trials into a number of promising new treatments which we hope will give more options for children with this devastating disease.”

Related Links:
Cancer Research UK
The Royal Marsden 
University College London