Comparing diagnostic performance of 131I-metaiodobenzylguanidine (131I-MIBG) and 99mTc-hydrazinonicotinyl-Tyr3-Octreotide (99mTc-HYNIC-TOC) in diagnosis and localization of pheochromocytoma and neuroblastoma

Document Type : Original Article

Authors

Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Introduction: The present study was aimed to assess the diagnostic performance of the two imaging methods of 131I-metaiodobenzylguanidine (131I-MIBG) and 99mTc-hydrazinonicotinyl-Tyr3-Octreotide (99mTc-HYNIC-TOC) in diagnosis and localization of pheochromocytoma and neuroblastoma.
Methods: This study was conducted on 40 consecutive patients with positive pathological results for pheochromocytoma or neuroblastoma. The patients underwent both I-131 131I-MIBG and octreotide scintigraphies. By using the findings of cytopathology, biomarkers, imaging studies, as well as the results of a six-month follow-up, a composite reference standard (CRS) was defined as the diagnostic gold standard.
Results:Overall comparison of these two agents revealed higher sensitivity for 131I-MIBG than octreotide study both in patient-based analysis (100% vs. 80.9%, respectively), and lesion-based analysis (94.4% vs. 80.56%, respectively). In pheochromocytoma 131I-MIBG and octreotide are both highly sensitive (100%), while 131I-MIBG is more specific (100% vs. 87.5%). In neuroblastoma, 131I-MIBG is more sensitive than octreotide (100% vs. 81.25%).
Conclusion: Our study shows superiority of 131I-MIBG over octreotide scanning in detection of both neuroblastoma and pheochromocytoma lesions. However, a combination of these two diagnostic tools provides more complete information on the nature and the site of lesions. The first suggested study is 131I-MIBG scanning, and if it is not available, or detecting precise location of all lesions is of concern, octreotide scanning can be helpful as a complementary study.  Furthermore, in case of octreotide positive lesions, follow-up can be performed with octreotide scan with less radiation burden.

Keywords

Main Subjects

References

  1. Därr R, Lenders JW, Hofbauer LC, Naumann B, Bornstein SR, Eisenhofer G. Pheochromocytoma - update on disease management. Ther Adv Endocrinol Metab. 2012 Feb;3(1):11-26.
  2. Prejbisz A, Lenders JW, Eisenhofer G, Januszewicz A. Cardiovascular manifestations of phaeochromocytoma. J Hypertens. 2011 Nov;29(11):2049-60.
  3. Plouin PF, Amar L, Dekkers OM, Fassnacht M, Gimenez-Roqueplo AP, Lenders JW, Lussey-Lepoutre C, Steichen O; Guideline Working Group. European Society of Endocrinology Clinical Practice Guideline for long-term follow-up of patients operated on for a phaeochromocytoma or a paraganglioma. Eur J Endocrinol. 2016 May;174(5):G1-G10. 
  4. Lenders JW, Duh QY, Eisenhofer G, Gimenez-Roqueplo AP, Grebe SK, Murad MH, Naruse M, Pacak K, Young WF Jr; Endocrine Society. Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014 Jun;99(6):1915-42. 
  5. Szolar DH, Korobkin M, Reittner P, Berghold A, Bauernhofer T, Trummer H, Schoellnast H, Preidler KW, Samonigg H. Adrenocortical carcinomas and adrenal pheochromocytomas: mass and enhancement loss evaluation at delayed contrast-enhanced CT. Radiology. 2005 Feb;234(2):479-85.
  6. Blake MA, Kalra MK, Maher MM, Sahani DV, Sweeney AT, Mueller PR, Hahn PF, Boland GW. Pheochromocytoma: an imaging chameleon. Radiographics. 2004 Oct;24 Suppl 1:S87-99. 
  7. Wiseman GA, Pacak K, O'Dorisio MS, Neumann DR, Waxman AD, Mankoff DA, Heiba SI, Serafini AN, Tumeh SS, Khutoryansky N, Jacobson AF. Usefulness of 123I-MIBG scintigraphy in the evaluation of patients with known or suspected primary or metastatic pheochromocytoma or paraganglioma: results from a prospective multicenter trial. J Nucl Med. 2009 Sep;50(9):1448-54. 
  8. Fottner C, Helisch A, Anlauf M, Rossmann H, Musholt TJ, Kreft A, Schadmand-Fischer S, Bartenstein P, Lackner KJ, Klöppel G, Schreckenberger M, Weber MM. 6-18F-fluoro-L-dihydroxyphenylalanine positron emission tomography is superior to 123I-metaiodobenzyl-guanidine scintigraphy in the detection of extraadrenal and hereditary pheochromocytomas and paragangliomas: correlation with vesicular monoamine transporter expression. J Clin Endocrinol Metab. 2010 Jun;95(6):2800-10. 
  9. Jacobson AF, Deng H, Lombard J, Lessig HJ, Black RR. 123I-meta-iodobenzylguanidine scintigraphy for the detection of neuroblastoma and pheochromocytoma: results of a meta-analysis. J Clin Endocrinol Metab. 2010 Jun;95(6):2596-606. 
  10. Brodeur GM, Castleberry RP. Neuroblastoma.Pizzo PA, Poplack DG, eds. Principles and practices of pediatric oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 933-70.
  11. Naranjo A, Parisi MT, Shulkin BL, London WB, Matthay KK, Kreissman SG, Yanik GA. Comparison of ¹²³I-metaiodobenzylguanidine (MIBG) and ¹³¹I-MIBG semi-quantitative scores in predicting survival in patients with stage 4 neuroblastoma: a report from the Children's Oncology Group. Pediatr Blood Cancer. 2011 Jul 1;56(7):1041-5.
  12. Melzer HI, Coppenrath E, Schmid I, Albert MH, von Schweinitz D, Tudball C, Bartenstein P, Pfluger T. ¹²³I-MIBG scintigraphy/SPECT versus ¹⁸F-FDG PET in paediatric neuroblastoma. Eur J Nucl Med Mol Imaging. 2011 Sep;38(9):1648-58.
  13. Ziessman HA, O'Malley JP, Thrall JH. Nuclear Medicine: The Requisites. Philadelphia, PA: Elsevier Mosby; 2014. p. 265-287
  14. Yamamoto S, Hellmann P, Sundin A. Tumors of the adrenal glands. In: Aktolun C, Goldsmith S. Nuclear Oncology. Philadelphia: Wolters Kluwer; 2014. p. 251-264.
  15. Welander J, Söderkvist P, Gimm O. Genetics and clinical characteristics of hereditary pheochromocytomas and paragangliomas. Endocr Relat Cancer. 2011 Dec 1;18(6):R253-76.
  16. Ohira M, Nakagawara A. Global genomic and RNA profiles for novel risk stratification of neuroblastoma. Cancer Sci. 2010 Nov;101(11):2295-301.
  17. Bombardieri E, Giammarile F, Aktolun C, Baum RP, Bischof Delaloye A, Maffioli L, Moncayo R, Mortelmans L, Pepe G, Reske SN, Castellani MR, Chiti A; European Association for Nuclear Medicine. 131I/123I-metaiodobenzylguanidine (mIBG) scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging. 2010 Dec;37(12):2436-46.
  18. Rubello D, Bui C, Casara D, Gross MD, Fig LM, Shapiro B. Functional scintigraphy of the adrenal gland. Eur J Endocrinol. 2002 Jul;147(1):13-28.
  19. Olivier P, Colarinha P, Fettich J, Fischer S, Frökier J, Giammarile F, Gordon I, Hahn K, Kabasakal L, Mann M, Mitjavila M, Piepsz A, Porn U, Sixt R, van Velzen J. Guidelines for radioiodinated MIBG scintigraphy in children. Eur J Nucl Med Mol Imaging. 2003 May;30(5):B45-50.
  20. Intenzo CM, Jabbour S, Lin HC, Miller JL, Kim SM, Capuzzi DM, Mitchell EP. Scintigraphic imaging of body neuroendocrine tumors. Radiographics. 2007 Sep-Oct;27(5):1355-69.
  21. Joseph S, Wang YZ, Boudreaux JP, Anthony LB, Campeau R, Raines D, O'Dorisio T, Go VL, Vinik AI, Cundiff J, Woltering EA. Neuroendocrine tumors: current recommendations for diagnosis and surgical management. Endocrinol Metab Clin North Am. 2011 Mar;40(1):205-31.
  22. Torre JJ, Bloomgarden ZT, Dickey RA, Hogan MJ, Janick JJ, Jyothinagaram SG, Siragy HM; AACE Hypertension Task Force. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the diagnosis and treatment of hypertension. Endocr Pract. 2006 Mar-Apr;12(2):193-222.
  23. Ilias I, Chen CC, Carrasquillo JA, Whatley M, Ling A, Lazúrová I, Adams KT, Perera S, Pacak K. Comparison of 6-18F-fluorodopamine PET with 123I-metaiodobenzylguanidine and 111in-pentetreotide scintigraphy in localization of nonmetastatic and metastatic pheochromocytoma. J Nucl Med. 2008 Oct;49(10):1613-9.
  24. King KS, Chen CC, Alexopoulos DK, Whatley MA, Reynolds JC, Patronas N, Ling A, Adams KT, Xekouki P, Lando H, Stratakis CA, Pacak K. Functional imaging of SDHx-related head and neck paragangliomas: comparison of 18F-fluorodihydroxyphenylalanine, 18F-fluorodopamine, 18F-fluoro-2-deoxy-D-glucose PET, 123I-metaiodobenzylguanidine scintigraphy, and 111In-pentetreotide scintigraphy. J Clin Endocrinol Metab. 2011 Sep;96(9):2779-85.
  25. Lastoria S, Maurea S, Vergara E, Acampa W, Varrella P, Klain M, Muto P, Bernardy JD, Salvatore M. Comparison of labeled MIBG and somatostatin analogs in imaging neuroendocrine tumors. Q J Nucl Med. 1995 Dec;39(4 Suppl 1):145-9.
  26. Koopmans KP, Jager PL, Kema IP, Kerstens MN, Albers F, Dullaart RP. 111In-octreotide is superior to 123I-metaiodobenzylguanidine for scintigraphic detection of head and neck paragangliomas.  J Nucl Med. 2008 Aug;49(8):1232-7.
  27. Shalaby-Rana E, Majd M, Andrich MP, Movassaghi N. In-111 pentetreotide scintigraphy in patients with neuroblastoma. Comparison with I-131 MIBG, N-Myc oncogene amplification, and patient outcome. Clin Nucl Med. 1997 May;22(5):315-9.
  28.  Ueberberg B, Tourne H, Redmann A, Walz MK, Schmid KW, Mann K, Petersenn S. Differential expression of the human somatostatin receptor subtypes sst1 to sst5 in various adrenal tumors and normal adrenal gland. Horm Metab Res. 2005 Dec;37(12):722-8.
  29. Limouris GS, Giannakopoulos V, Stavraka A, Toubanakis N, Vlahos L. Comparison of In-111 pentetreotide, Tc-99m (V)DMSA and I-123 mlBG scintimaging in neural crest tumors. Anticancer Res. 1997 May-Jun;17(3B):1589-92.
  30. Tenenbaum F, Lumbroso J, Schlumberger M, Mure A, Plouin PF, Caillou B, Parmentier C. Comparison of radiolabeled octreotide and meta-iodobenzylguanidine (MIBG) scintigraphy in malignant pheochromocytoma. J Nucl Med. 1995 Jan;36(1):1-6.
  31. Furuta N, Kiyota H, Yoshigoe F, Hasegawa N, Ohishi Y. Diagnosis of pheochromocytoma using [123I]-compared with [131I]-metaiodobenzylguanidine scintigraphy. Int J Urol. 1999 Mar;6(3):119-24.
  32. Nielsen JT, Nielsen BV, Rehling M. Location of adrenal medullary pheochromocytoma by I-123 metaiodobenzylguanidine SPECT. Clin Nucl Med. 1996 Sep;21(9):695-9.
  33. van der Harst E1, 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 DJ. [(123)I]metaiodobenzylguanidine and [(111)In]octreotide uptake in begnign and malignant pheochromocytomas. J Clin Endocrinol Metab. 2001 Feb;86(2):685-93.

Files

Share

How to cite

Statistics