Virotta G, Medolago G, Zappone C, Moschini L, Torre L, Mazzoni A, Bertocchi C
Division of Nuclear Medicine, Ospedali Riuniti, Bergamo, Italy.
Q J Nucl Med. 1995 Dec;39(4 Suppl 1):9-12.
Chemodectoma is a rare, slow growing neoplasm with local aggressiveness and a high rate of residuals after surgery, arising from paraganglionic tissue (neural crest) and therefore able to take up Metaiodobenzylguanidine (MIBG). The aim of this study was to evaluate the diagnostic accuracy of 123I-MIBG Single Photon Emission Computed Tomography (SPECT) in comparison to Selective Digital Angiography (SDA), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). We studied 50 patients (41 women, 9 men) mean age 56 years (range 14-79), with diagnostic suspicion of chemodectoma (CH). There were 2 groups of patients: Group A (26 patients) examined before Surgery and Group B (24 patients) examined after surgery. SPECT of the head and neck region was performed 4 hours after i.v. administration of 185 MBq of 123I-MIBG. All patients were pre-treated with iodine solution. We performed a qualitative evaluation of the reconstructed slices. In Group A, all patients with CH (24) showed accumulation of MIBG in agreement with SDA, CT and MRI: 2 patients (histologically one had a cordoma, the other metastasis of papillary thyroid carcinoma), did not show any accumulation of 123I-MIBG. In Group B, 6 patients showed accumulation of 123I-MIBG in local residuals, and 9 were negative. Six patients with a lesion smaller than 1.5 cm were negative. Three patients had a positive scan but no lesion on SDA, CT and MRI. 123I-MIBG SPECT proved to be useful procedure in the diagnosis of untreated CH. During follow-up after surgery this procedure may assume a role in the perspective of radiometabolic therapy with 131I-MIBG.
化学感受器瘤是一种罕见的、生长缓慢的肿瘤，具有局部侵袭性，术后残留率高，起源于副神经节组织（神经嵴），因此能够摄取间碘苄胍（MIBG）。本研究的目的是评估123I-MIBG单光子发射计算机断层扫描（SPECT）与选择性数字血管造影（SDA）、计算机断层扫描（CT）和磁共振成像（MRI）相比的诊断准确性。我们研究了50例患者（41名女性，9名男性），平均年龄56岁（范围14 - 79岁），临床怀疑为化学感受器瘤（CH）。患者分为两组：A组（26例患者）在手术前进行检查，B组（24例患者）在手术后进行检查。静脉注射185 MBq的123I-MIBG后4小时，对患者的头颈部区域进行SPECT检查。所有患者均预先用碘溶液进行预处理。我们对重建后的切片进行了定性评估。在A组中，所有CH患者（24例）MIBG均有摄取，与SDA、CT和MRI结果一致：2例患者（组织学检查1例为脊索瘤，另1例为甲状腺乳头状癌转移）未显示123I-MIBG摄取。在B组中，6例患者在局部残留病灶处显示123I-MIBG摄取，9例为阴性。6例病灶小于1.5 cm的患者为阴性。3例患者扫描结果为阳性，但SDA、CT和MRI均未发现病灶。123I-MIBG SPECT被证明是诊断未治疗的CH的有用方法。在手术后的随访期间，该方法在131I-MIBG放射性代谢治疗方面可能发挥作用。
