Completely Negative 123 I-MIBG SPECT/CT, but Strong Positive 68 Ga-DOTATATE PET/CT of Multiple Metastases in a Neuroblastoma Patient.
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A 6-year-old boy with a history of neuroblastoma following chemotherapy presented with positive bone marrow minimal residual disease (MRD). 123 I-MIBG SPECT/CT did not reveal any avid lesions, given the positive MRD and high clinical suspicion for disease recurrence, a subsequent 68 Ga-DOTATATE PET/CT was performed. This modality identified multiple metastatic lesions that were avid for 68 Ga-DOTATATE. Histopathological examination confirmed the diagnosis of neuroblastoma metastasis. This case underscores the complementary diagnostic value of 68 Ga-DOTATATE PET/CT in patients with negative 123I-MIBG findings, particularly when there are indications of potential relapse.