MIBG molecular imaging for evaluating response to chemotherapy in patients with malignant pheochromocytoma: preliminary results(251 views) Maurea S, Fiumara G, Pellegrino T, Zampella E, Assante R, Mainenti PP, Cuocolo A
Department of Advanced Biomedical Sciences, University Federico II, Napoli, Italy.
SDN Foundation, Institute of Diagnostic and Nuclear Development, Napoli, Italy
Institute of Biostructures and Bioimages, National Council of Research, Napoli, Italy
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Averbuch, S. D., Steakley, C. S., Young, R. C., Malignant pheochromocytoma: Effective treatment with a combination of cyclophosphamide, vincristine, and dacarbazine (1988) Ann Intern Med, 109, pp. 267-273. , PMid: 3395037
Nguyen, H. H., Proye, C. A. G., Carnaille, B., Combemale, F., Pattou, F. N., Huglo, D., Tumour size: The only predictive factor for 131I MIBG uptake in phaeochromocytoma and paraganglioma (1999) Australian and New Zealand Journal of Surgery, 69 (5), pp. 350-353. , DOI 10. 1046/j. 1440-1622. 1999. 01570. x
Timmers, H. J., Chen, C. C., Carrasquillo, J. A., Comparison of 18f-fluoro-l-dopa 18f-fluoro-deoxyglucose and 18f-fluorodopamine pet and 123i-mibg scintigraphy in the localization of pheochromocytoma and paraganglioma (2009) J Clin Endocrinol Metab, 94, pp. 4757-4767. , doi: 10. 1210/jc. 2009-1248. PMid: -19864450
Adler, J. T., Meyer-Rochow, G. Y., Chen, H., Pheochromocytoma: Current approaches and future directions (2008) Oncologist, 13, pp. 779-793. , doi101634/theoncologist2008-0043 PMid18617683
Kim, E. E., Haynie, T. P., Role of nuclear medicine in chemotherapy of malignant lesions (1985) Semin Nucl Med, 15, pp. 12-20. , PMid: 3885397
Cook, G. J. R., Fogelman, I., The role of nuclear medicine in monitoring treatment in skeletal malignancy (2001) Seminars in Nuclear Medicine, 31 (3), pp. 206-211
Weber, W. A., Figlin, R., Monitoring cancer treatment with PET/CT: Does it make a difference? (2007) Journal of Nuclear Medicine, 48 (1 SUPPL.), pp. 36S-44S. , http: //jnm. snmjournals. org/cgi/reprint/48/1_suppl/36S
Intenzo, C. M., Jabbour, S., Lin, H. C., Scintigraphic imaging of body neuroendocrine tumors (2007) Radiographics, 27, pp. 1355-1369. , doi: 10. 1148/rg. 275065729. PMid: 17848696
MIBG molecular imaging for evaluating response to chemotherapy in patients with malignant pheochromocytoma: preliminary results
Malignant pheochromocytomas respond to chemotherapy with a reduction in tumor size and catecholamine secretion. We investigated the usefulness of molecular imaging with meta-iodobenzylguanidine (MIBG) for evaluating the effects of chemotherapy in patients with malignant pheochromocytoma. Six patients were studied before and after 6 ± 4 months of combination chemotherapy with cyclophosphamide, vincristine, and dacarbazine. Urinary catecholamines, metanephrines, and vanillylmandelic acid (VMA) levels were measured before and after chemotherapy. [(131)I]MIBG uptake was calculated for each tumor lesion on images before and after chemotherapy. An intensity ratio (IR) of abnormal to normal tissue count density was used to evaluate the change in lesion activity with therapy. Urinary catecholamines, metanephrines, and VMA significantly decreased with chemotherapy. MIBG uptake decreased in most lesions and the reduction in overall IR correlated with the reduction in urinary VMA. However, the change in individual lesions was variable and MIBG IR did not change or increased in a number of lesions. In conclusion, MIBG imaging is useful in the evaluation of patients with malignant pheochromocytoma who are receiving chemotherapy. It can provide not only a measure of overall effectiveness of treatment but also allows a lesion-by-lesion evaluation of the heterogeneity of response to chemotherapy.
MIBG molecular imaging for evaluating response to chemotherapy in patients with malignant pheochromocytoma: preliminary results