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lüll (123)I metaiodobenzylguanidine and (111)In octreotide uptake in begnign and malignant pheochromocytomas van der Harst E; de Herder WW; Bruining HA; Bonjer HJ; de Krijger RR; Lamberts SW; van de Meiracker AH; Boomsma F; Stijnen T; Krenning EP; Bosman FT; Kwekkeboom DJJ Clin Endocrinol Metab 2001[Feb]; 86 (2): 685-93Selecting 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.|3-Iodobenzylguanidine/*pharmacokinetics[MESH]|Adolescent[MESH]|Adrenal Gland Neoplasms/*diagnostic imaging/metabolism/mortality/pathology/surgery[MESH]|Adult[MESH]|Aged[MESH]|Disease-Free Survival[MESH]|Humans[MESH]|Indium Radioisotopes/*pharmacokinetics[MESH]|Iodine Radioisotopes/*pharmacokinetics[MESH]|Middle Aged[MESH]|Multiple Endocrine Neoplasia Type 2a/diagnostic imaging[MESH]|Multiple Endocrine Neoplasia Type 2b/diagnostic imaging[MESH]|Neoplasm Metastasis[MESH]|Octreotide/*pharmacokinetics[MESH]|Pheochromocytoma/*diagnostic imaging/metabolism/mortality/pathology/surgery[MESH]|Radionuclide Imaging[MESH]|Radiopharmaceuticals/*pharmacokinetics[MESH]|Receptors, Somatostatin/analysis[MESH]|Recurrence[MESH]|Retrospective Studies[MESH]|Survival Rate[MESH]|Tissue Distribution[MESH] |