Troncone L, Rufini V, Montemaggi P, Danza F M, Lasorella A, Mastrangelo R
Department of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy.
Eur J Nucl Med. 1990;16(4-6):325-35. doi: 10.1007/BF00842788.
The authors' experience of more than 5 years in the diagnostic and therapeutic use of radioiodinated MIBG in neural crest tumors is reported. 123I/131I-MIBG scintigraphy was performed in 158 patients: 75 suspected (24 proven) pheochromocytomas (pheos), 43 neuroblastomas (NB), 20 medullary thyroid carcinomas (MTC), 6 ganglioneuromas, 5 carcinoids and 1 insulinoma. Eight cases of tumors not originating from the neural crest were also investigated. The diagnostic sensitivity of the method was above 90% both in pheos and NB (primary tumors and bone metastases). The examination was less effective in localizing MTC (sensitivity = 64.4% in primary or residual/recurrent tumors). The scintigraphic outcome was negative in ganglioneuromas, carcinoids and insulinoma. Specificity was very high (greater than 95%), and no false positive results were found in tumors not deriving from the neural crest. 131I-MIBG treatment was administered to four patients with malignant pheo, nine with NB and four with MTC. Therapy resulted in a complete response in one pheo, two NB and one MTC treated after surgery or at diagnosis (one NB); it gave partial response and prolonged remission in five advanced cases (one pheo, two NB and two MTC); it resulted in temporary stabilization of the disease in one pheo and two NBs; it was ineffective in four cases.
本文报告了作者在神经嵴肿瘤放射性碘化间碘苄胍（MIBG）诊断和治疗应用方面超过5年的经验。对158例患者进行了123I/131I-MIBG闪烁扫描：75例疑似（24例确诊）嗜铬细胞瘤（嗜铬瘤）、43例神经母细胞瘤（NB）、20例甲状腺髓样癌（MTC）、6例神经节瘤、5例类癌和1例胰岛素瘤。还对8例非神经嵴起源的肿瘤进行了研究。该方法在嗜铬瘤和NB（原发肿瘤和骨转移）中的诊断敏感性均高于90%。该检查在定位MTC方面效果较差（原发或残留/复发性肿瘤的敏感性为64.4%）。神经节瘤、类癌和胰岛素瘤的闪烁扫描结果为阴性。特异性非常高（大于95%），在非神经嵴起源的肿瘤中未发现假阳性结果。对4例恶性嗜铬瘤、9例NB和4例MTC患者进行了131I-MIBG治疗。治疗在1例嗜铬瘤、2例NB和1例手术后或诊断时治疗的MTC（1例NB）中导致完全缓解；在5例晚期病例（1例嗜铬瘤、2例NB和2例MTC）中产生部分缓解并延长缓解期；在1例嗜铬瘤和2例NB中导致疾病暂时稳定；在4例中无效。
