18F-MFBG Uptake From Multiple Focal “Hot Spots” to Superscan in a Pediatric Patient With High-risk Neuroblastoma

A 5-year-old girl diagnosed with high-risk neuroblastoma enrolled in our clinical trial underwent ¹⁸ F-MFBG PET/CT, showing multiple discrete focal “hot spots.” Bone marrow aspiration confirmed metastatic neuroblastoma involvement. After 5 cycles of immunotherapy and chemotherapy, follow-up ¹⁸ F-MFBG PET/CT revealed a marked shift in biodistribution: the multiple discrete focal “hot spots” pattern resolved, and diffuse and intense skeletal tracer uptake—consistent with a superscan pattern emerged—including both newly developed lesions—indicative of progressive disease. The present case showed the temporal evolution of ¹⁸ F-MFBG uptake from multiple focal “hot spots” to a superscan.