Monitoring the Efficacy of Iodine-131-MIBG Therapy using Fluorine-18-FDG-PET Monitoring der Jod-131-MIBG-Therapie unter Anwendung der Fluor-18-Desoxyglukose-PET

C. Menzel, S. Graichen, U. Berner, J. H. Risse, M. Diehl, N. Döbert, N. Hamscho, F. Grünwald
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引用次数: 12

Abstract

Summary: Background: The purpose of this study was to assess the potential of fluorine-18 fluoro-2-deoxy-d-glucose positron emission tomography (18F-FDG-PET) for monitoring the efficacy of iodine-131 metaiodobenzylguanidine (131I-MIBG) therapy in neuroendocrine tumours.

Methods: A total of seven 131I-MIBG therapies with 3.7 to 10.2 GBq were carried out in three patients suffering respectively from a phaeochromocytoma, a paraganglioma and a metastatic neuroendocrine tumour of an unknown primary. The post-therapeutic whole-body scintigrams were compared with the results of six 18F-FDG-PET studies performed at the time of the therapies. One patient received three PET scans prior to each one of the MIBG therapies, and one patient was studied twice.

Results: 18F-FDG uptake in tumour sites seemed to correlate well with tumour differentiation, showing no uptake in one patient with a highly differentiated neuroendocrine tumour, and moderate-to-intense uptake in the two other patients with metastatic disease. Those tumour sites that had a simultaneous positive uptake in both the MIBG scintigram and the PET scan showed response to therapy as a continuous reduction in MIBG uptake over time. They also showed a qualitative decrease in FDG accumulation during the follow-up. This was associated with a decrease in the mean and maximum standard uptake values of more than 50 % in some metastases, while the X-ray computed tomography showed no decrease in tumour volume. Two patients revealed additional metastases that were unknown on the basis of prior diagnostic or therapeutic PET scans and radiological follow-up.

Conclusions: It may be concluded from these cases that 18F-FDG-PET is a valuable tool for an initial metabolic staging of neuroendocrine tumours prior to 131I-MIBG therapy, as it can reveal tumour sites beyond the reach of radioisotope therapy. It may also be of importance in assessing therapeutic potential in those tumour sites that do show positive MIBG uptake.

它也发现了一些关于方法测爱奥德尼的结果
摘要:背景:本研究的目的是评估氟-18氟-2-脱氧-d-葡萄糖正电子发射断层扫描(18F-FDG-PET)监测碘-131间氧苄基胍(131I-MIBG)治疗神经内分泌肿瘤的疗效。方法:对3例分别患有嗜铬细胞瘤、副神经节瘤和原发不明的转移性神经内分泌肿瘤的患者进行7种131I-MIBG治疗,3.7 - 10.2 GBq。将治疗后的全身闪烁图与治疗时进行的6次18F-FDG-PET研究结果进行比较。一名患者在每次MIBG治疗前接受了三次PET扫描,一名患者接受了两次研究。结果:肿瘤部位的18F-FDG摄取似乎与肿瘤分化密切相关,在一名高度分化的神经内分泌肿瘤患者中没有摄取,而在另外两名转移性疾病患者中则有中等至强烈的摄取。那些在MIBG闪烁图和PET扫描中同时呈阳性摄取的肿瘤部位,随着时间的推移,MIBG摄取持续减少,对治疗有反应。在随访期间,他们还显示FDG积累的定性减少。这与一些转移瘤的平均和最高标准摄取值减少50%以上有关,而x射线计算机断层扫描显示肿瘤体积没有减少。两名患者在先前诊断或治疗性PET扫描和放射随访的基础上发现了未知的其他转移灶。结论:从这些病例中可以得出结论,18F-FDG-PET是131I-MIBG治疗前神经内分泌肿瘤初始代谢分期的有价值的工具,因为它可以显示放射性同位素治疗无法达到的肿瘤部位。在评估那些确实显示MIBG摄取阳性的肿瘤部位的治疗潜力时,它也可能是重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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