By Judy S. E. Moyes MA (Cantab), FRCP (C), V. Ralph McCready DSc, MRCP, FRCR, Ann C. Fullbrook DCR(T), DRI (auth.)
Using metaiodobenzylguanidine as a radiopharmaceutical deals interesting new percentages, and recognized gurus proportion their adventure during this quantity. it truly is designed as a realistic reduction in case you are commencing to hire the fairly new approach to mIGB within the prognosis and remedy of neuroblastoma. Profusely illustrated case histories reveal the conventional and pathological uptake of mIGB and help the newbie to properly interpret the scintigrams. information of the options for assessing the radiation dose to the tumors present process targetted radiotherapy are given, and the sensible information required for its secure use within the pediatric atmosphere are mentioned.
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Extra info for Neuroblastoma: mIBG in its Diagnosis and Management
Shapiro B. ' (1983b) Inverse relationship between cardiac accumulation of meta[13 1I]iodobenzylguanidine (1-131 MIGB) and circulating catecholamines in suspected phaeochromocytoma. J Nue! Med 24:1127-1134 Nakajo M. Shapiro B. Sisson JC et a!. (1984) Salivary gland accumulation of meta-[13 1I]iodobenzylguanidine. J Nue! Med 25:2-6 Wieland DM. Wu J-L. E eta!. (1980) Radiolabeled adrenergic neuron-blocking agents; adrenomedullary imaging with [13 1I]iodobenzylguanidine. J Nue! Med 21:349-353 46 The Skulk 123I-mIBG Scintigram at 4 hours Fig.
Teenager: posterior of legs Fig. iii. Infant: anterior of legs 54 - - - The Skull and Chest: 131I-mIBG Scintigram at 24 hours Fig. i. Child: right lateral skull Fig. ii. -sm Fig. i. ii. Child: posterior chest and abdomen Fig. iii. Teenager: anterior chest Fig. iv. i. Infant: anterior abdomen and pelvis Fig. ii. iii. Child: anterior abdomen and pelvis Fig. iv. Child: posterior abdomen and pelvis Fig. i. Child: anterior of upper legs Fig. ii. Child: anterior of lower legs Key: h. heart; L. liver; b.
When neuroblastoma spreads from its site of origin it may infiltrate the bone marrow or the cortical bone, either separately or together. On mIBG scintigraphy normal bone and bone marrow do not take up *I-mIBG, and therefore cannot be distinguished from the diffuse background activity. i-vi illustrate a patient with and without bone marrow involvement by neuroblastoma. To assess whether the bone marrow is infiltrated by tumour the long bones of the arms and legs should be examined first since they are usually the sites which demonstrate it with the most clarity.