Enhanced tumor uptake in neuroendocrine tumors after intraarterial application of 131I-MIBG.
131I-labeled metaiodobenzylguanidine (MIBG) is an established treatment modality for neuroendocrine tumors. Because of low tumor doses, it has a predominantly palliative character. Our approach was to investigate whether intraarterial application of 131I-MIBG has the potential to enhance tumor uptake.


METHODS
Seventeen patients with primary or metastasized neuroendocrine tumors received intraarterial treatment with 131I-MIBG, and 12 of these patients also had intravenous treatment. Every patient underwent intravenous 131I-MIBG whole-body scanning before therapy. For quantification, a tumor-to-whole-body ratio was calculated from the diagnostic and 24-h posttreatment scans.


RESULTS
Compared with the intravenous application, intraarterial 131I-MIBG treatment provided an up to 4-fold higher tumor uptake. Mean uptake was enhanced by 69%, but this varied widely between patients. We did not observe any immediate complications from catheterization. Carcinoid-related side effects were noted in 7 of 17 patients and were not different from those seen with intravenous application.


CONCLUSIONS
Intraarterial treatment with 131I-MIBG is a safe alternative to intravenous application and provides a 69% higher mean tumor uptake. We propose to attempt intraarterial MIBG treatment in every patient to assess its potential benefit.
Brogsitter
Claudia
C
Department of Nuclear Medicine, University of Dresden, Dresden, Germany. Claudia.Brogsitter@uniklinikum-dresden.de
Pinkert
Jörg
J
Bredow
Jan
J
Kittner
Thomas
T
Kotzerke
Jörg
J
D019797:3-Iodobenzylguanidine / Q000494:pharmacology*; D000368:Aged; D000970:Antineoplastic Agents / Q000494:pharmacology*; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000000981:diagnostic imaging*; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000494:pharmacology*; D051598:Whole Body Imaging
D000970:Antineoplastic Agents; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine