[(123)I]metaiodobenzylguanidine and [(111)In]octreotide uptake in begnign and malignant pheochromocytomas
- PMID: 11158032
- DOI: 10.1210/jcem.86.2.7238
[(123)I]metaiodobenzylguanidine and [(111)In]octreotide uptake in begnign and malignant pheochromocytomas
Abstract
Selecting the appropriate approach for resection and follow-up of pheochromocytomas (PCCs) is highly dependent upon reliable localization and exclusion of multifocal, bilateral, or metastatic disease. Metaiodobenzylguanidine (MIBG) scintigraphy was developed for functional localization of catecholamine-secreting tissues. Somatostatin receptor imaging (SRI) has a high sensitivity for localizing head and neck paragangliomas, but studies of intraabdominal PCCs are rare. In this study we review our experience of [(123)I]MIBG and SRI, performed since 1983 and 1989, respectively, in the work-up of primary and recurrent PCCs. Scintigraphic results were correlated with catecholamine secretion, size and site, malignancy, associated tumor syndromes, and morphological features. [(123)I]MIBG scans were performed in a total of 75 patients, in 70 cases before resection of primary PCCs and in 5 cases because of recurrent disease. Ninety-one PCCs were resected. The overall detection rates were 83.3% and 89.8% for PCCs larger than 1.0 cm. Multifocal disease was detected in 4 patients with [(123)I]MIBG. [(123)I]MIBG uptake correlated with greater size of PCC (r = 0.33; P = 0.008) and greater concentration of plasma epinephrine (r = 0.32; P = 0.006). [(123)I]MIBG-negative PCCs (n = 14) had significantly (P = 0.01) smaller diameters than [(123I)]MIBG-positive tumors. Furthermore, [(123)I]MIBG uptake was significantly higher in unilateral (P = 0.02), benign (P = 0.02), sporadic (P = 0.02), intraadrenal (P = 0.02), and capsular invasive (P = 0.03) PCCs than in bilateral, malignant, MEN2A/2B-related, extraadrenal, and noninvasive PCCs, respectively. The detection rate of SRI was only 25% (8 of 32) for primary benign PCCs. In 14 patients metastases occurred, which were effectively visualized with [(123)I]MIBG in 8 of 14 cases. SRI was able to detect metastases in 7 of 8 cases, including 3 [(123)I]MIBG-negative metastatic cases. In addition, [(123)I]MIBG and SRI detected 2 recurrences. In conclusion, [(123)I]MIBG uptake is correlated with the size, epinephrine production, and site of PCCs. Its role in bilateral and MEN2A/2B-related PCCs seems limited. In cases of recurrent elevation of catecholamines, localization of metastases and/or recurrence should be attempted with [(123)I]MIBG scintigraphy. In suspicious metastatic PCCs, SRI might be considered to supplement [(123)I]MIBG scintigraphy.
Similar articles
-
Usefulness of Somatostatin Receptor Scintigraphy (Tc-[HYNIC, Tyr3]-Octreotide) and 123I-Metaiodobenzylguanidine Scintigraphy in Patients with SDHx Gene-Related Pheochromocytomas and Paragangliomas Detected by Computed Tomography.Neuroendocrinology. 2015;101(4):321-30. doi: 10.1159/000381458. Epub 2015 Mar 13. Neuroendocrinology. 2015. PMID: 25791839
-
The evolution in the use of MIBG scintigraphy in pheochromocytomas and paragangliomas.Hormones (Athens). 2013 Jan-Mar;12(1):58-68. doi: 10.1007/BF03401287. Hormones (Athens). 2013. PMID: 23624132 Review.
-
Imaging of neuroendocrine tumors.Semin Nucl Med. 2006 Jul;36(3):228-47. doi: 10.1053/j.semnuclmed.2006.03.007. Semin Nucl Med. 2006. PMID: 16762613 Review.
-
A meta-iodobenzylguanidine scintigraphic scoring system increases accuracy in the diagnostic management of pheochromocytoma.Endocr Relat Cancer. 2006 Jun;13(2):525-33. doi: 10.1677/erc.1.01066. Endocr Relat Cancer. 2006. PMID: 16728579
-
Comparison of radiolabeled octreotide and meta-iodobenzylguanidine (MIBG) scintigraphy in malignant pheochromocytoma.J Nucl Med. 1995 Jan;36(1):1-6. J Nucl Med. 1995. PMID: 7799058
Cited by
-
Pheochromocytoma With High Adrenocorticotropic Hormone Production Capacity Without Pigmentation and Cushingoid Symptoms: A Case Report With a Literature Review.Cureus. 2024 Feb 1;16(2):e53358. doi: 10.7759/cureus.53358. eCollection 2024 Feb. Cureus. 2024. PMID: 38435205 Free PMC article.
-
Targeted radionuclide therapy in endocrine-related cancers: advances in the last decade.Front Endocrinol (Lausanne). 2023 Nov 20;14:1187870. doi: 10.3389/fendo.2023.1187870. eCollection 2023. Front Endocrinol (Lausanne). 2023. PMID: 38053729 Free PMC article. Review.
-
Image-Guided Precision Medicine in the Diagnosis and Treatment of Pheochromocytomas and Paragangliomas.Cancers (Basel). 2023 Sep 21;15(18):4666. doi: 10.3390/cancers15184666. Cancers (Basel). 2023. PMID: 37760633 Free PMC article. Review.
-
Does Octreoscan add value in the differential diagnosis of parapharyngeal space lesions?Radiol Bras. 2021 Nov-Dec;54(6):367-374. doi: 10.1590/0100-3984.2020.0177. Radiol Bras. 2021. PMID: 34866696 Free PMC article.
-
Approach to the Patient with an Incidental Adrenal Mass.Med Clin North Am. 2021 Nov;105(6):1047-1063. doi: 10.1016/j.mcna.2021.06.009. Epub 2021 Sep 9. Med Clin North Am. 2021. PMID: 34688414 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical