18F-MFBG PET/CT or PET/MR in Imaging Patients with Neuroendocrine Malignancies

Inclusion Criteria

• PHASE I: Eligible patients include patients with histologically proven neuroendocrine tumors (paraganglioma, PHEO [pheochromocytoma], or well differentiated neuroendocrine tumor [NET] of the lung or gastrointestinal [GI] system) or neuroblastoma (NB); patients, who have NB, the diagnosis must be in accordance with the International Criteria, i.e., either histopathology or bone marrow involvement; patients must be able to undergo PET scan without sedation
• PHASE I: All patients must have MIBG-avid disease and evaluable disease on a prior MIBG scan at the time of enrollment onto the protocol
• PHASE I: Performance status >= 60 on Karnofsky scale for patients > 16 years of age and > 60 on Lansky scale for patients < 16 years of age
• PHASE I: Cardiac, pulmonary, gastrointestinal and neurologic toxicity should all be =< grade 2
• EXPANSION COHORT: Patients with diagnosis of NB (in accordance with the International Criteria, i.e., either histopathology or bone marrow involvement)
• EXPANSION COHORT: Patients must be able to undergo PET scan without sedation
• EXPANSION COHORT: Patients must have MIBG-avid disease and evaluable disease on prior MIBG scan at the time of enrollment onto the protocol * If MIBG scan is available within 4 weeks of MFBG, with no intervening treatment, MIBG scan will not be repeated * If prior MIBG scan is available > 4 weeks of MFBG, MIBG scan will be done within a week (prior or after) of MFBG
• EXPANSION COHORT: Performance status of >= 60 on Karnofsky scale for patients > 16 years of age and > 60 on Lansky scale for patients =< 16 years of age
• EXPANSION COHORT: Cardiac, pulmonary, gastrointestinal and neurologic toxicity should all be =< grade 2
• EXPANSION COHORT: Patients with positive lesion detection by 18F-MFBG may be eligible for repeat imaging scan, at the discretion of principal investigator (PI) or study investigator(s)

Exclusion Criteria

• Major organ toxicity including cardiac, pulmonary, gastrointestinal and neurologic toxicity more than grade 2
• Active serious infections not controlled by antibiotics
• Inability or unwillingness to undergo PET scanning
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
• Women who are pregnant or breastfeeding
• Patient has an active malignancy of metastatic potential other than the known NE tumor for the past 3 years
• Patients should not have received chemotherapy or radiation therapy (localized radiation therapy is allowed to non-evaluable sites) between prior 123I-MIBG scan and 18F-MFBG administration
• Patients requiring anesthesia, who are not already undergoing anesthesia for standard-of-care procedures