Multiple Bone Metastases Exhibiting Exceptionally High 18F-MFBG Uptake Exceeding Physiological Bladder Activity in a Patient With Neuroblastoma.

In neuroblastoma, 18F-MFBG uptake in metastatic lesions is typically lower than physiological urinary bladder activity. We present a case of a 6-year-old boy with high-risk neuroblastoma who underwent multimodal therapy. A follow-up 18F-MFBG PET/CT performed for treatment response assessment demonstrated markedly increased tracer accumulation in multiple skeletal metastases, with an SUVmax of 77.1, surpassing concurrent bladder activity. This case demonstrates that osseous metastases in patients with neuroblastoma may exhibit such pronounced 18F-MFBG uptake.