The use of an 18F-labeled radiopharmaceutical for positron emission tomography (PET) imaging of sympathetic neuronal activity has a tremendous clinical impact because it circumvents the substantial drawbacks of the prototypical imaging agent, 123I-metaiodobenzylguanidine (MIBG). We describe a 14-year-old male patient who had neuroblastoma and underwent 18F-fluoropropylbenzylguanidine (FPBG) PET/computed tomography (CT). We compared the findings of 18F-FPBG PET/CT with those of 123I-MIBG γ scintigraphy. 18F-FPBG PET/CT readily demonstrated a focal lesion in the left tibia, but the lesion was not seen using 123I-MIBG scintigraphy. Surgical resection proved the presence of a neuroblastoma lesion in the left tibia. To the best of our knowledge, our study was the first to use an 18F-labeled radiopharmaceutical for evaluating sympathetic neuronal activity in neuroblastoma. We suggest that 18F-FPBG is a promising PET agent for imaging sympathetic neuronal activity in neuroblastoma.

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