Clarke S E, Lazarus C R, Edwards S, Murby B, Clarke D G, Roden T M, Fogelman I, Maisey M N
Department of Nuclear Medicine, Guy's Hospital, London, United Kingdom.
J Nucl Med. 1987 Dec;28(12):1820-5.
We report our experience using [131I]metaiodobenzylguanidine (MIBG) to image nine patients with proven medullary carcinoma of the thyroid (MCT). Positive uptake was seen in four patients, equivocal uptake in one patient, and no uptake in four patients. Data is presented to demonstrate the pharmacokinetics of [131I]MIBG in three of the patients studied. Two patients, with diarrhea and severe pain from known bone metastases and positive uptake on [131I]MIBG diagnostic scanning, subsequently received therapeutic doses of [131I]MIBG, with marked improvement in both pain and diarrhea, but no evidence of significant biochemical response. Iodine-131 MIBG uptake in patients with MCT is variable, and gives a higher false-negative rate than is found when using [131I]MIBG to image other neuroectodermally derived tumors. The therapeutic potential of [131I]MIBG in patients with MCT warrants further evaluation, in view of the symptomatic relief experienced following therapy doses in two patients with extensive disease.
我们报告了使用[131I]间碘苄胍（MIBG）对9例经证实的甲状腺髓样癌（MCT）患者进行成像的经验。4例患者出现阳性摄取，1例患者摄取不明确，4例患者无摄取。本文展示了所研究的3例患者中[131I]MIBG的药代动力学数据。2例已知有骨转移且伴有腹泻和剧痛的患者，在[131I]MIBG诊断扫描中呈阳性摄取，随后接受了治疗剂量的[131I]MIBG，疼痛和腹泻均有明显改善，但无明显生化反应的证据。MCT患者中碘-131 MIBG的摄取情况不一，与使用[131I]MIBG对其他神经外胚层来源肿瘤进行成像相比，其假阴性率更高。鉴于2例患有广泛性疾病的患者在接受治疗剂量后症状得到缓解，[131I]MIBG在MCT患者中的治疗潜力值得进一步评估。
