Takenaka Junki, Watanabe Shiro, Abe Takashige, Takeuchi Satoshi, Hirata Kenji, Kimura Rina, Ishii Hiroshi, Wakabayashi Naoto, Majigsuren Mungunkhuyag, Kudo Kohsuke
Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
Department of Nuclear Medicine, Hokkaido University Hospital, Sapporo 060-8648, Japan.
Pharmaceuticals (Basel). 2025 Jan 26;18(2):165. doi: 10.3390/ph18020165.
: Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors that produce catecholamines. Unresectable or metastatic PPGLs are treated with [I]metaiodobenzylguanidine (MIBG), but MIBG avidity is often heterogeneous. Identifying predictive factors for non-avid lesions on scintigraphy is clinically important. The primary objective of this study was to investigate the relationship between MIBG avidity and catecholamine secretion patterns in patients with unresectable or metastatic PPGLs. : This retrospective study included 27 patients treated with [I]MIBG for unresectable/metastatic PPGLs between 2001 and 2024. Patients received a single intravenous dose of [I]MIBG (5.5-7.4 GBq), with post-therapy scintigraphy performed 3-7 days later. Non-avid lesions were assessed by imaging and confirmed using CT, MRI, and FDG-PET. Clinical factors, including age, sex, prior treatments, metastasis sites, and urine catecholamines, were evaluated using univariate logistic analysis. Predictive factors were assessed via receiver operating characteristic curves. : Non-avid lesions were found in nine patients (33.3%). These patients were younger (median age 38 vs. 62.5 years) and had higher urine dopamine levels (median 1510 vs. 779 μg/day) than those without non-avid lesions. Younger age (odds ratio: 0.892, < 0.01) and higher urinary dopamine levels (odds ratio: 1.003, < 0.01) were significantly associated with non-avid lesions. All patients > 45 years with urinary dopamine < 1190 μg/day had no non-avid lesions, whereas patients < 45 years with urinary dopamine > 1190 μg/day had non-avid lesions. : Age and urinary dopamine levels may predict non-avid lesions in unresectable/metastatic PPGLs, aiding treatment decisions for [I]MIBG therapy. This article is a revised and expanded version of a paper entitled "Urine dopamine level and age can predict non-avid lesion on scintigraphy after I-131 MIBG treatment for unresectable/metastatic PPGL", which was presented at SNMMI 2024, Toronto, from 8 June to 11 June 2024.
嗜铬细胞瘤和副神经节瘤（PPGLs）是罕见的产生儿茶酚胺的神经内分泌肿瘤。不可切除或转移性PPGLs采用[I]间碘苄胍（MIBG）治疗，但MIBG摄取通常存在异质性。识别闪烁显像中非摄取性病变的预测因素具有重要临床意义。本研究的主要目的是探讨不可切除或转移性PPGLs患者中MIBG摄取与儿茶酚胺分泌模式之间的关系。
本回顾性研究纳入了2001年至2024年间接受[I]MIBG治疗不可切除/转移性PPGLs的27例患者。患者静脉注射单次剂量的[I]MIBG（5.5 - 7.4 GBq），治疗后3 - 7天进行闪烁显像。通过影像学评估非摄取性病变，并使用CT、MRI和FDG - PET进行确认。使用单因素逻辑回归分析评估包括年龄、性别、既往治疗、转移部位和尿儿茶酚胺在内的临床因素。通过受试者操作特征曲线评估预测因素。
9例患者（33.3%）发现有非摄取性病变。这些患者比无非摄取性病变的患者更年轻（中位年龄38岁对62.5岁）且尿多巴胺水平更高（中位值1510对779μg/天）。年龄较小（比值比：0.892，<0.01）和尿多巴胺水平较高（比值比：1.003，<0.01）与非摄取性病变显著相关。所有年龄>45岁且尿多巴胺<1190μg/天的患者均无非摄取性病变，而年龄<45岁且尿多巴胺>1190μg/天的患者有非摄取性病变。
年龄和尿多巴胺水平可能预测不可切除/转移性PPGLs中的非摄取性病变，有助于[I]MIBG治疗的治疗决策。本文是一篇题为“尿多巴胺水平和年龄可预测I - 131 MIBG治疗不可切除/转移性PPGL后闪烁显像中的非摄取性病变”的论文的修订和扩展版本，该论文于2024年6月8日至11日在多伦多举行的SNMMI 2024上发表。
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