Muros M A, Llamas-Elvira J M, Rodríguez A, Ramírez A, Gómez M, Arráez M A, Valéncia E, Vílchez R
Department of Nuclear Medicine, Hospital Virgen de las Nieves, Granada, Spain.
Nucl Med Commun. 1998 Aug;19(8):735-42. doi: 10.1097/00006231-199808000-00003.
Chemodectomas, or glomus tumours, are unusual head and neck paragangliomas. A non-invasive imaging technique, 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy, has long been used for the diagnosis of all types of paraganglioma. The aim of this study was to evaluate and compare classic 123I-MIBG scintigraphy with the more recent 111In-pentetreotide scintigraphy in the diagnosis and location of chemodectomas. We performed 123I-MIBG and 111In-pentetreotide scintigraphy in eight patients (7 females, 1 male) with histologically or radiologically confirmed chemodectomas (five carotid body and three jugulotympanic chemodectomas). 123I-MIBG uptake was visualized in four patients on planar views and SPET images (sensitivity 50%); uptake was low in three patients. Using 111In-pentetreotide scintigraphy, all chemodectomas in eight patients were visualized (sensitivity 100%) and 111In-pentetreotide uptake was high in all cases. In conclusion, our results indicate that 111In-pentetreotide scintigraphy is superior to 123I-MIBG scintigraphy in the diagnosis and location of chemodectomas. In-pentetreotide or 123I-MIBG uptake suggests a neuroendocrine origin, providing important functional information in the diagnosis of chemodectomas. Moreover, 111In-pentetreotide scintigraphy permits a good classification of patients with or without somatostatin receptors in the chemodectoma in the application of pharmacological therapy with somatostatin analogues to inoperable tumours. The main therapeutic action of cold somatostatin analogues is to inhibit hormonal hypersecretion in different neuroendocrine tumours. In chemodectomas, however, the most important effect of somatostatin analogues is to reduce tumour volume or inhibit growth progression.
化学感受器瘤，即球旁细胞瘤，是一种罕见的头颈部副神经节瘤。123I-间碘苄胍（123I-MIBG）闪烁扫描作为一种非侵入性成像技术，长期以来一直用于诊断所有类型的副神经节瘤。本研究的目的是评估并比较经典的123I-MIBG闪烁扫描与较新的111In-喷替肽闪烁扫描在化学感受器瘤诊断和定位中的应用。我们对8例经组织学或放射学确诊为化学感受器瘤（5例颈动脉体瘤和3例颈静脉鼓室化学感受器瘤）的患者（7例女性，1例男性）进行了123I-MIBG和111In-喷替肽闪烁扫描。在平面图像和单光子发射断层扫描（SPET）图像上，4例患者可见123I-MIBG摄取（灵敏度50%）；3例患者摄取较低。使用111In-喷替肽闪烁扫描时，8例患者的所有化学感受器瘤均可见（灵敏度100%），且所有病例中111In-喷替肽摄取均较高。总之，我们的结果表明，在化学感受器瘤的诊断和定位方面，111In-喷替肽闪烁扫描优于123I-MIBG闪烁扫描。111In-喷替肽或123I-MIBG摄取提示神经内分泌起源，为化学感受器瘤的诊断提供重要的功能信息。此外，在对无法手术切除的肿瘤应用生长抑素类似物进行药物治疗时，111In-喷替肽闪烁扫描有助于对化学感受器瘤中有无生长抑素受体的患者进行良好分类。生长抑素类似物的主要治疗作用是抑制不同神经内分泌肿瘤中的激素过度分泌。然而，在化学感受器瘤中，生长抑素类似物最重要的作用是减小肿瘤体积或抑制生长进展。
