ARRS 2022 Abstracts


E1857. Significance of Curie Scoring in MIBG Imaging and Therapy in Cases of Neuroblastoma
  1. Pokhraj Suthar; Rush University Medical Center
  2. Khushboo Gupta; Rush University Medical Center
Neuroblastoma is an embryonal tumor of the sympathetic nervous system, accounting for 15% of pediatric cancer deaths in the United States. There is good prognosis in some patients; however, survival remains poor in high-risk patients despite aggressive multimodality therapies. Patients responding to induction chemotherapy have good survival outcomes. This educational exhibit highlights the MIBG scan and Curie score in staging and follow up of these patients.

Educational Goals / Teaching Points
This exhibit will review indications for MIBG scan and therapy in cases of neuroblastoma. Learners will understand various components of the Curie scoring algorithm and utility of the Curie score in staging, recurrence, and follow up.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
123I-MIBG whole-body scintigraphy is an important imaging technique for detecting neuroblastoma, staging, and evaluating treatment response. Children’s Oncolgy Group (COG) has accepted the Curie scoring method as a current standard for comparing treatment response with 123I- MIBG scans. The Curie Scoring algorithm divides the body into nine skeletal sections and a tenth soft-tissue section. The 10 sections are graded for the extent of MIBG avidity on a scale of 0 to 3: 0 = no involvement, 1 = one site, 2 = more than one site, 3 = diffuse involvement (> 50% of the segment). The Curie score is the sum of all 10 segments. On follow up scans, Curie scores are compared to study the disease burden. Patients with a Curie score more than 2 following induction chemotherapy have poor outcomes compared to patients with a Curie score less than or equal to 2. There is, however, no correlation between Curie score at diagnosis and survival. In this exhibit, we present cases of MIBG scintigraphy, application of Curie score, treatment, and follow up in cases of neuroblastoma.

This review of serial MIBG scintigraphy, application of Curie scoring, treatment, and follow up in cases of neuroblastoma aims to strengthen the interpretation and knowledge of the reading radiologists, nuclear medicine physicians, and treating oncologists.