Abstract

Neuroblastoma is the most common extracranial malignancy in childhood. This embryonal tumor originates from the neural crest and is classified within the group of neuroendocrine tumors. It can arise anywhere along the sympathetic nervous system or in the adrenal medulla. At the time of diagnosis, nearly half of patients present with metastatic disease. Nuclear medicine imaging methods play a critical role in the diagnosis and follow-up of neuroblastoma. In addition to metaiodobenzylguanidine (MIBG) imaging, which is the current standard nuclear imaging modality, the development of novel positron emission tomography-compatible radiopharmaceuticals in recent years has opened new horizons for the molecular-level assessment of the disease. Patients with neuroblastoma are stratified into low-, intermediate-, and high-risk groups, with treatment strategies differing substantially among these categories. Various therapeutic approaches are selected according to risk classification and patient-specific characteristics. Through theranostic strategies targeting biological markers expressed by neuroblastoma cells, several radionuclide therapies have been developed, most notably MIBG therapy, which has long been established as a cornerstone in this field. This review focuses on nuclear medicine applications in the diagnosis and treatment of neuroblastoma.