Brain uptake of iodine-131 metaiodobenzylguanidine following therapy of malignant pheochromocytoma
Date
1998, 1998
Authors
Dwamena B.A.
Zempel S.
Klopper J.F.
Van Heerden B.
Wieland D.
Shapiro B.
Dwamena B.A.
Zempel S.
Klopper J.F.
Van Heerden B.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Intracranial metaiodobenzylguanidine (MIBG) uptake is occasionally and only faintly visualized on diagnostic studies. Recently, intense normal cerebellar uptake was described on posttherapy MIBG images. Experience at the University of Michigan with posttherapy MIBG scintigraphy of pheochromocytoma was reviewed. The patterns and correlates of intracranial uptake after therapeutic I-131 MIBG in 25 patients (61 patient treatment encounters) were evaluated by review of records and blinded consensus interpretation of diagnostic and posttherapeutic MIBG scans. Thirty-nine (64%) patient treatment encounters demonstrated at least faint (grade 1) MIBG uptake in one or more brain sites; the most common site was the cerebellum. There was a statistically significant relation between intracranial uptake and 1) size of therapeutic dose and 2) patient age, but no relation between intracranial uptake and gender, body mass index, plasma epinephrine level, plasma norepinephrine level, urine metanophrine level, or the therapy-to-imaging interval. Although the influence of age on the pattern and intensity of intracranial uptake is unexplained, the relation to therapy dose may be explained by the possible generation of MIBG metabolites that can cross the blood-brain barrier (high activity administered and the delay until imaging). Further studies are needed to define mechanisms of intracranial uptake and relation to responses and toxicity after MIBG therapy of neuroendocrine tumors.
Intracranial metaiodobenzylguanidine (MIBG) uptake is occasionally and only faintly visualized on diagnostic studies. Recently, intense normal cerebellar uptake was described on posttherapy MIBG images. Experience at the University of Michigan with posttherapy MIBG scintigraphy of pheochromocytoma was reviewed. The patterns and correlates of intracranial uptake after therapeutic I-131 MIBG in 25 patients (61 patient treatment encounters) were evaluated by review of records and blinded consensus interpretation of diagnostic and posttherapeutic MIBG scans. Thirty-nine (64%) patient treatment encounters demonstrated at least faint (grade 1) MIBG uptake in one or more brain sites; the most common site was the cerebellum. There was a statistically significant relation between intracranial uptake and 1) size of therapeutic dose and 2) patient age, but no relation between intracranial uptake and gender, body mass index, plasma epinephrine level, plasma norepinephrine level, urine metanophrine level, or the therapy-to-imaging interval. Although the influence of age on the pattern and intensity of intracranial uptake is unexplained, the relation to therapy dose may be explained by the possible generation of MIBG metabolites that can cross the blood-brain barrier (high activity administered and the delay until imaging). Further studies are needed to define mechanisms of intracranial uptake and relation to responses and toxicity after MIBG therapy of neuroendocrine tumors.
Intracranial metaiodobenzylguanidine (MIBG) uptake is occasionally and only faintly visualized on diagnostic studies. Recently, intense normal cerebellar uptake was described on posttherapy MIBG images. Experience at the University of Michigan with posttherapy MIBG scintigraphy of pheochromocytoma was reviewed. The patterns and correlates of intracranial uptake after therapeutic I-131 MIBG in 25 patients (61 patient treatment encounters) were evaluated by review of records and blinded consensus interpretation of diagnostic and posttherapeutic MIBG scans. Thirty-nine (64%) patient treatment encounters demonstrated at least faint (grade 1) MIBG uptake in one or more brain sites; the most common site was the cerebellum. There was a statistically significant relation between intracranial uptake and 1) size of therapeutic dose and 2) patient age, but no relation between intracranial uptake and gender, body mass index, plasma epinephrine level, plasma norepinephrine level, urine metanophrine level, or the therapy-to-imaging interval. Although the influence of age on the pattern and intensity of intracranial uptake is unexplained, the relation to therapy dose may be explained by the possible generation of MIBG metabolites that can cross the blood-brain barrier (high activity administered and the delay until imaging). Further studies are needed to define mechanisms of intracranial uptake and relation to responses and toxicity after MIBG therapy of neuroendocrine tumors.
Description
Keywords
adrenalin; metadrenalin; noradrenalin; adolescent; adrenalin blood level; adult; aged; article; blood brain barrier; brain scintiscanning; catecholamine urine level; cerebellum; clinical protocol; controlled study; female; human; intravenous drug administration; isotope labeling; major clinical study; male; medical record; noradrenalin blood level; pheochromocytoma; 3-Iodobenzylguanidine; Adolescent; Adrenal Gland Neoplasms; Adrenergic Agonists; Adrenergic alpha-Agonists; Adult; Age Factors; Aged; Blood-Brain Barrier; Body Mass Index; Brain; Cerebellum; Epinephrine; Evaluation Studies; Female; Humans; Male; Metanephrine; Middle Aged; Neuroendocrine Tumors; Norepinephrine; Pheochromocytoma; Radiopharmaceuticals; Radiotherapy Dosage; Retrospective Studies; Sex Factors; Single-Blind Method, adrenalin, metadrenalin, noradrenalin, adolescent, adrenalin blood level, adult, aged, article, blood brain barrier, brain scintiscanning, catecholamine urine level, cerebellum, clinical protocol, controlled study, female, human, intravenous drug administration, isotope labeling, major clinical study, male, medical record, noradrenalin blood level, pheochromocytoma, 3-Iodobenzylguanidine, Adolescent, Adrenal Gland Neoplasms, Adrenergic Agonists, Adrenergic alpha-Agonists, Adult, Age Factors, Aged, Blood-Brain Barrier, Body Mass Index, Brain, Cerebellum, Epinephrine, Evaluation Studies, Female, Humans, Male, Metanephrine, Middle Aged, Neuroendocrine Tumors, Norepinephrine, Pheochromocytoma, Radiopharmaceuticals, Radiotherapy Dosage, Retrospective Studies, Sex Factors, Single-Blind Method
Citation
Clinical Nuclear Medicine
23
7
Clinical Nuclear Medicine
23
7
23
7
Clinical Nuclear Medicine
23
7