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The diagnostic and therapeutic utility of radioiodinated metaiodobenzy1guanidine (MIBG)

5 years of experience

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Abstract

The authors' experience of more than 5 years in the diagnostic and therapeutic use of radioiodinated MIBG in neural crest tumors is reported.123I/131I-MIBG scintigraphhy was performed in 158 patients: 75 suspected (24 proven) pheochromocytomas (pheos), 43 neuroblastomas (NB), 20 medullary thyroid carcinomas (MTC), 6 ganglioneuromas, 5 carcinoids and 1 insulinoma. Eight cases of tumors not originating from the neural crest were also investigated. The diagnostic sensitivity of the method was above 90% both in pheos and NB (primary tumors and bone metastases). The examination was less effective in localizing MTC (sensitivity=64.4% in primary or residual/recurrent tumors). The scintigraphie outcome was negative in ganglioneuromas, carcinoids and insulinoma. Specificity was very high (> 95%), and no false positive results were found in tumors not deriving from the neural crest.

131I-MIBG treatment was administered to four patients with malignant pheo, nine with NB and four with MTC. Therapy resulted in a complete response in one pheo, two NB and one MTC treated after surgery or at diagnosis (one NB), it gave partial response and prolonged remission in five advanced cases (one pheo, two NB and two MTC); it resulted in temporary stabilization of the disease in one pheo and two NBs, it was ineffective in four cases.

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References

  • Ackery DM, Tippett PA, Condon BR, Sutton HE, Wyeth P (1984) New approach to the localisation of phaeochromocytoma: imaging with iodine-131-metaiodobenzylguanidine. Br Med J 288:1587–1591

    Google Scholar 

  • Adolph J, Kimmig B, Eisenhut M, Georgi P (1986) Therapie von karzinoiden mit131-J-meta-Jod-benzylguanidin. In: Hofer R, Bergmann H (eds) Radioaktive Isotope in Klinik und Forschung, 17 Band, 1 Teil. Gastainer Internationale Symposium, Hegermann, Vienna, pp 501–507

  • Chatal JF, Charbonnel B (1985) Comparison of iodobenzylguanidine imaging with computed tomography in locatiog pheochromocytoma. J Clin Endocrinol Metab 61:769–772

    Google Scholar 

  • Clarke SEM, Lazarus CR, Wraight P, Sampson C, Maisey MN (1988) Pentavalent [99mTc]DMSA, [131I]MIBG, and [99mTc]MDP. An evaluation of three imaging techniques in patients with medullary carcinoma of the thyroid. J Nucl Med 29:33–38

    Google Scholar 

  • Endo K, Shiomi K, Kasagi K, Komishi J, Torizuka K, Nakao PK, Tanimura N (1984) Imaging of medullary thyroid cancer with131I-MIBG. Lancet ii:233

    Google Scholar 

  • Feine U, Klingebiel T, Treuner J (1986) Therapy of the neuroblastoma with131I-MIBG. In: Winkler C (ed) Nuelear medicine in clinical oncology. Springer, Heidelberg New York Berlin, pp 321–326

    Google Scholar 

  • Feldman JM, Blinder RA, Lucas KJ, Coleman RE (1986) Iodine-131 metaiodobenzylguanidine scintigraphy of carcinoid tumors. J Nucl Med 27:1691–1696

    Google Scholar 

  • Fischer M, Kamanabroo D, Sanderkamp H, Proske T (1984a) Scintigraphie imaging of carcinoid tumors with131I-MIBG. Lancet ii:165

    Google Scholar 

  • Fischer M, Winterberg B, Zidek W, Müller-Rensing R, Vetter H (1984b) Nuklearmedizinische Therapie des Phaochromozytoms. Schweiz Med Wochenschr 114:1841–1843

    Google Scholar 

  • Francis IR, Glazer GM, Shapiro B, Sisson JC, Gross BH (1983) Complementary roles of CT and131I-MIBG scintigraphy in diagnosing pheochromocytoma. AJR 141:719–725

    Google Scholar 

  • Geatti O, Shapiro B, Sisson JC, Hutchinson RJ, Mallette S, Eyre P, Beierwaltes WH (1985) Iodine-131-metaiodobenzylguanidine for the location of ncuroblastoma: preliminary experience in ten cases. J Nucl Med 26:736–742

    Google Scholar 

  • Gétin F, Rohmer V, Saint-André JP, Jallet P, Bigorgne JC (1985) Localisation du cancer médullaire de la thyroide par la scintigraphie à la métaiodobenzylguanidine. Press Méd 14:597

    Google Scholar 

  • Hilditch TE, Connell JCM, Elliott AT, Murray T, Reed NS (1986) Poor results with technetium-99m (V)DMS and iodine-131 MIBG in the imaging of medullary thyroid carcinoma. J Nucl Med 27:1150–1153

    Google Scholar 

  • Hoefnagel CA, Voûte PA, de Kraker J, Marcuse HR (1985) Totalbody scintigraphy with131I-metaiodobenzylguanidine for detection of ncuroblastoma. Diagn Imag Clin Med 54:21–27

    Google Scholar 

  • Hoefnagel CA, den Hartog Jager FCA, van Gennip AH, Marcuse HR, Taal BG (1986) Diagnosis and treatment of a carcinoid tumor using iodine-131 metaiodobenzylguanidine. Clin Nucl Med 11: 150–152

    Google Scholar 

  • Hoefnagel CA, Voûte PA, de Kraker J, Marcuse HR (1987) Radionuclide diagnosis and thcrapy of neural crest tumors using iodine-131 metaiodobenzylguanidine. J Nucl Med 28:308–314

    Google Scholar 

  • Hoefnagel CA, Delprat CC, Zanin D, van der Schoot JB (1988) New radionuclide tracers for the diagnosis and therapy of medullary thyroid carcinoma. Clin Nucl Med 13:159–165

    Google Scholar 

  • Horne T, Hawkins LA, Britton KE, Granowska M, Bouloux P, Besser GM (1984) Imaging of phaeochromocytoma and adrenal medulla with123I-meta-iodobenzylguanidine. Nucl Med Commun 5:763–768

    Google Scholar 

  • Kimmig B, Brandeis WE, Eisenhut M (1984) Scintigraphy of a neuroblastoma with I-131 meta-iodobenzylguanidine. J Nucl Med 25:773–775

    Google Scholar 

  • Mastrangelo R, Troncone L, Lasorella A, Riccardi R, Montemaggi P, Rufini V (1989)131I-metaiodobenzylguanidine in the treatment of ncuroblastoma at diagnosis. Am J Pediatr Hematol Oncol 11: 28–31

    Google Scholar 

  • Maul FD, Manegold K, Nitz Chr, Gerein V, Happ J, Schwabe D, Tezak St, Baum RP, Szepesi S, Klinter D, Kornhuber B, Hör G (1986) Zur Therapie des Neuroblastoms mit J-131-JBG: Frankfurter Ergebnisse von 27 Behandlungen. In: Hofer R, Bergmann H (eds) Radioaktive Isotope in Klinik und Forschung, 17 Band, 1 Teil. Gastainer International Symposium, Hegermann, Vienna, pp 509–515

  • McEwan AJ, Shapiro B, Sisson JC, Beierwaltes WH, Ackery DM (1985) Radio-iodobenzylguanidine for the scintigraphie location and therapy of adrenergic tumors. Semin Nucl Med 15:132–153

    Google Scholar 

  • Munkner T (1985)131I-meta-iodobenzylguanidine scintigraphy of neuroblastomas. Semin Nucl Med 15:154–160

    Google Scholar 

  • Nakajo M, Taguchi M, Shimabukuro K, Shinohara S (1986) Iodine-131-MIBG uptake in a small cell carcinoma of the lung (letter to the Editor). J Nucl Med 27:1785–1786

    Google Scholar 

  • Perdrisot R, Rohmer V, Lejeune JJ, Bigorgne JC, Jallet P (1988) Thyroid uptake of MIBG in Sipple's syndrome. Eur J Nucl Med 14:37–38

    Google Scholar 

  • Poston GJ, Thomas AMK, MacDonald DWR, Karvounaris D, Henderson BL, George P, Lynn JA, Lavender JP (1986) Imaging of metastatic medullary carcinoma of the thyroid with131I-meta-iodobenzylguanidine. Nucl Med Commun 7:215–221

    Google Scholar 

  • Rufini V, Troncone L, Valentini AL, Danza FM (1988) Comparison of radiolabelled MIBG scintigraphy with computed tomography in the location of pheochromocytomas. Radiol Med 76:466–470

    Google Scholar 

  • Shapiro B, Coop JE, Sisson JC, Eyre PL, Wallis J, Beierwaltes WH (l985) Iodine-131 Metaiodobenzyl-guanidine for the locating of suspected pheochromocytoma: Experience in 400 cases. J Nucl Med 26:576–585

    Google Scholar 

  • Shulkin B, Sisson JC, Koral KF, Shapiro B, Wang X, Johnson J (1988) Conjugate view gammacamera method for estimating tumor uptake of iodine-131 metaiodobenzyl-guanidine. J Nucl Med 29:542–548

    Google Scholar 

  • Sisson JC, Frager MS, Valk TW, Gross MD, Swanson DP, Wieland DM, Tobes MC, Beierwaltes WH, Thompson NW (1981) Scintigraphic localization of pheochromocytoma. N Engl J Med 305:12–17

    Google Scholar 

  • Sisson JC, Shapiro B, Beierwaltes WH, Glowniak JV, Nakajo M, Mangner TJ, Carey JE, Swanson DP, Copp JE, Satterlee WG, Wieland DM (1984) Radiopharmaeeutical treatment of malignant pheochromocytoma. J Nucl Med 24:197–206

    Google Scholar 

  • Smit AJ, van Essen LH, Hollema H, Muskiet FAJ, Piers DA (1984) Meta [I-131] Iodobenzylguanidine uptake in a nonsecreting paraganglioma. J Nucl Med 25:984–986

    Google Scholar 

  • Sutton H, Wyeth P, Allen AP, Thurtle OA, Hames TK, Cawley MID, Ackery D (1982) Disseminated malignant phaeochromocytoma: localisation with iodine-131-labelled meta-iodobenzylguanidine. Br Med J 285:1153–1154

    Google Scholar 

  • Troncone L, Maini CL, De Rosa G, Corsello SM, Rufini V, Mattei O, Bonifazi N (1984) Scintigraphie localization of a disseminated malignant pheochromocytoma with the use of131I-meta-iodobenzylguanidine. Eur J Nucl Med 9:429–432

    Google Scholar 

  • Troncone L, Rufini V, Maini CL, Valenza V, Danza FM, Lasorella A (1986)131I-MIBG in the diagnosis of neuroendocrine tumors other than pheochromocytomas. Rad Med 72:963–968

    Google Scholar 

  • Troncone L, Riccardi R, Montemaggi P, Rufini V, Lasorella A, Mastrangelo R (1987) Treatment of neuroblastoma with131I-metaiodobenzylguanidine. Med Ped Oncol 15:220–223

    Google Scholar 

  • Von Moll L, McEwan AJ, Shapiro B, Sisson JC, Gross MD, Lloyd R, Beals E, Beierwaltes WH, Thompson NW (1987) Iodine-131 MIBG scintigraphy of neuroendocrine tumors other than pheochromocytoma and neuroblastoma. J Nucl Med 28:979–988

    Google Scholar 

  • Wieland DM, Wu JL, Brown LE, Mangner TJ, Swanson DP, Beierwaltes WH (1980) Radiolabeled adrenergic neuron-blocking agents: adrenomedullary imaging with131I-iodobenzylguanidine. J Nucl Med 21:348–353

    Google Scholar 

  • Wieland DM, Brown LE, Tobes MC, Rogers WL, Marsh DD, Mangner TJ, Swanson DP, Beierwaltes WH (1981) Imaging the primate adrenal medulla with [123I] and [131I] meta-iodobenzylguanidine: concise communication. J Nucl Med 22:358–364

    Google Scholar 

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This work was supported by a grant from the National Research Council, Special Project “Oncology”, Contract number 88.00909.44 and from the “Associazione Italiana per la Ricerca sut Cancro”

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Troncone, L., Rufini, V., Montemaggi, P. et al. The diagnostic and therapeutic utility of radioiodinated metaiodobenzy1guanidine (MIBG). Eur J Nucl Med 16, 325–335 (1990). https://doi.org/10.1007/BF00842788

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  • DOI: https://doi.org/10.1007/BF00842788

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