Comparison of In-111 pentetreotide, Tc-99m (V)DMSA and I-123 mlBG scintimaging in neural crest tumors.
Comparison of In-111 pentetreotide, Tc-99m (V)DMSA and I-123 mlBG scintimaging in neural crest tumors.
复制标题
In-111 喷曲肽、Tc-99m (V)DMSA 和 I-123 mlBG 闪烁显像在神经嵴肿瘤中的比较。
作者：
G. Limouris;V. Giannakopoulos;A. Stavraka;N. Toubanakis;Lambros Vlahos
三种放射性标记物质，111 In-喷替曲肽，99 mTc-（V）DMSA和123 I-MIBG具有不同的动力学，但相似的肿瘤寻找行为，静脉注射，以评估和相关的转移性恶性嗜铬细胞瘤（4例），III和IV期神经母细胞瘤（7例）和甲状腺髓样癌（6例）的临床价值。所有II型嗜铬细胞瘤/神经母细胞瘤患者均在大约数周内接受了III MBq（3 mCi）剂量的123 I-MIBG和185 MBq（5 mCi）剂量的111 In-喷替曲肽静脉给药。此外，在这些患者中的4例以及所有甲状腺髓样癌患者中，在喷替曲肽/mIBG扫描前1周静脉内施用111 MBq（3 mCi）的99 mTc-（V）DMSA。4例患者（恶性嗜铬细胞瘤）共有7个病灶显示MIBG蓄积，其中3个部位有喷替曲肽，1个部位有（V）DMSA摄取，而7例患者（成神经细胞瘤）共有15个病灶显示MIBG蓄积，10个部位可检测到喷替曲肽，3个部位可检测到（V）DMSA。在这三种放射性示踪剂中，用于生长抑素受体鉴定的111 In-喷替曲肽主要用于123 I-MIBG成像为阴性的病灶。111 In-喷替曲肽不太可能取代123 I-MIBG作为一线常规诊断性甲状腺造影方法;与喷替曲肽或MIBG相比，（V）DMSA似乎仅在甲状腺髓样癌中高度敏感。
Three radiolabelled substances, 111In-pentetreotide, 99mTc-(V)DMSA and 123I-MIBG with different kinetics but similar tumor seeking behavior, were i.v. injected to assess and correlate their clinical value in metastatic malignant pheochromocytomas (4 patients), stage III and IV neuroblastomas (7 patients) and medullary thyroid carcinomas (6 patients). All II pheochromocytoma/neuroblastoma patients received i.v. a dose of III MBq (3 mCi) of 123I-MIBG and 185 MBq (5 mCi) of 111In-pentetreotide, within approximately weeks each other. Furthermore, in 4 of these patients as well as in all medullary thyroid carcinoma patients 111 MBq (3 mCi) of 99mTc-(V)DMSA were applied i.v. I week prior to the pentetreotide/mlBG scans. Four patients (malignant pheochromocytoma) with a total of 7 foci showing MIBG accumulation had 3 sites with pentetreotide and 1 site with (V)DMSA uptake, while in 7 patients (neuroblastora) with 15 foci showing MIBG accumulation 10 sites had detectable pentetreotide and 3 sites detectable (V)DMSA. Of the three radiotracers, 111In-pentetreotide used for somatostatin receptor identification holds promise mainly in cases where foci imaged with 123I-MIBG are negative. 111In-pentetreotide is unlikely to replace 123I-MIBG as a first-line routine diagnostic scintigraphic modality; compared to pentetreotide or MIBG, (V)DMSA seems to be highly sensitive only in medullary thyroid carcinomas.