Detecting Isolated Multifocal Leptomeningeal Metastases With 18F-MFBG PET/CT in a Pediatric Patient With High-risk Neuroblastoma.
Ziqing Shi, Lingling Zheng, Keyu Zhang et al.
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Case in brief
A 2-year-old girl with high-risk neuroblastoma had abdominal primary disease and multiple metastases on baseline 18F-MFBG PET/CT. After induction therapy, restaging showed no abnormal tracer uptake. At six-month follow-up, PET/CT demonstrated multifocal 18F-MFBG-avid lesions limited to the cranial compartment, without extracranial recurrence. Contrast-enhanced brain MRI subsequently confirmed leptomeningeal metastases.
What made this case unusual
The multifocal leptomeningeal disease was isolated to the cranial compartment, with no extracranial recurrence, and was detected on 18F-MFBG PET/CT.
Diagnostic / clinical pearl
In this case, cranial-only 18F-MFBG-avid lesions on surveillance PET/CT prompted MRI confirmation of leptomeningeal metastases.
Why it matters
The case illustrates the potential utility of 18F-MFBG PET/CT for detecting central nervous system involvement during surveillance of pediatric neuroblastoma.