Prolonged lung retention of iodine-123-MIBG in diabetic patients.
Iodine-123-MIBG has been introduced as a biochemical marker in assessing pulmonary endothelial cell integrity and myocardial beta-adrenergic sympathetic innervation. The aim of this study was to evaluate 123I-MIBG lung uptake in diabetic patients with and without coronary artery disease.


METHODS
Forty-four nonsmoking patients with normal respiratory function tests were included: 12 diabetics, 11 diabetics with coronary artery disease, 14 nondiabetic patients with coronary artery disease and 7 age-matched controls were imaged with 123I-MIBG and 201Tl scintigraphy. The lung retention of 123I-MIBG, cardiac sympathetic innervation (heart-to-upper mediastinum ratio of 123I-MIBG) and 201Tl lung-to-heart ratio were determined in all cases.


RESULTS
In diabetics with coronary artery disease, significantly prolonged lung retention and decreased cardiac uptake of 123I-MIBG were found. The lung retention of 123I-MIBG was inversely correlated with the heart-to-upper mediastinum ratio in this group. Lung-to-heart ratios of 201Tl were significantly increased in patients with coronary artery disease but there was no significant difference between diabetics and nondiabetics.


CONCLUSIONS
Prolonged lung retention of 123I-MIBG was associated with decreased cardiac sympathetic innervation in diabetic coronary artery disease patients. It seems that passive pulmonary congestion or cardiac dysfunction itself did not influence 123I-MIBG lung uptake. Increased lung extraction of 123I-MIBG is highly suggestive of ongoing pulmonary endothelial dysfunction together with ischemic events in diabetics.
Unlü
M
M
Department of Nuclear Medicine, Gazi University Medical Faculty, Ankara, Turkey.
Inanir
S
S
D019797:3-Iodobenzylguanidine; D016022:Case-Control Studies; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging / Q000294:innervation; D006801:Humans; D007457:Iodine Radioisotopes; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D019797:3-Iodobenzylguanidine