Hoefnagel C A
Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam.
Eur J Nucl Med. 1994 Jun;21(6):561-81. doi: 10.1007/BF00173045.
Two recently developed radiopharmaceuticals, iodine-131 metaiodobenzylguanidine (MIBG) and indium-111 pentetreotide, are currently being used for the diagnosis and therapy of neural crest tumours by interaction with the characteristic features of these tumours, such as an active uptake-1 mechanism at the cell membrane and the presence of vesicles or neurosecretory granules in the cytoplasm and of specific receptors at the cell membrane. This review focuses on the role of MIBG and somatostatin analogues in the management of neural crest tumours. A number of aspects of both tracers are compared and the cumulative results are reviewed. Other uses of these radiopharmaceuticals are mentioned. It is concluded that both 111In-pentetreotide and 123I/131I-MIBG are sensitive indicators of neural crest tumours, and have a complementary role. Unlike MIBG, 111In-pentetreotide is not specific for neural crest tumours, as scintigraphy is also positive in many other tumours, granulomas and autoimmune diseases. 131I-MIBG is effective in the therapy of several neural crest tumours; the biodistribution of 111In-pentetreotide at present does not allow radionuclide therapy using a beta-emitting label. However, as an indicator of somatostatin receptors, 111In-pentetreotide scintigraphy may be a predictor of response to palliative treatment with unlabelled octreotide. Recommendations for the use of these procedures are given.
最近研发的两种放射性药物，碘-131间碘苄胍（MIBG）和铟-111喷替肽，目前正通过与这些肿瘤的特征相互作用，用于神经嵴肿瘤的诊断和治疗，这些特征包括细胞膜上的主动摄取-1机制、细胞质中囊泡或神经分泌颗粒的存在以及细胞膜上特异性受体的存在。本综述重点关注MIBG和生长抑素类似物在神经嵴肿瘤管理中的作用。对这两种示踪剂的多个方面进行了比较，并对累积结果进行了综述。还提到了这些放射性药物的其他用途。结论是，铟-111喷替肽和碘-123/碘-131-MIBG都是神经嵴肿瘤的敏感指标，且具有互补作用。与MIBG不同，铟-111喷替肽对神经嵴肿瘤不具有特异性，因为闪烁扫描在许多其他肿瘤、肉芽肿和自身免疫性疾病中也呈阳性。碘-131-MIBG对几种神经嵴肿瘤的治疗有效；目前铟-111喷替肽的生物分布不允许使用发射β射线的标记物进行放射性核素治疗。然而，作为生长抑素受体的指标，铟-111喷替肽闪烁扫描可能是未标记奥曲肽姑息治疗反应的预测指标。文中给出了这些检查方法的使用建议。
