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Metaiodobenzylguanidine to Map Scintigraphically the Adrenergic Nervous System in Man

Division of Nuclear Medicine, Department of Internal Medicine, The University of Michigan Medical Center, Ann Arbor, Michigan

Correspondence: For reprints contact: James C. Sisson, MD, University of Michigan Medical Center, Division of Nuclear Medicine, 1500 Medical Center Dr., Ann Arbor, MI 48109-0028.

ABSTRACT

Metaiodobenzylguanidine (MIBG) localizes in adrenergic neurons; MIBG labeled with ¹²³I then serves as an analog of norepinephrine, and concentrations of [¹²³I]MIBG reflect sites of adrenergic neurons in organs. Movements of [¹²³I]MIBG into and out of organs were measured by quantitative scintigraphy in man. We perturbed adrenergic neuron function in several ways, and [¹²³I]MIBG concentrations in the heart were subsequently altered in patterns consistent with the concept that [¹²³I]MIBG resides mostly in adrenergic neurons. Uptake of [¹²³I]MIBG into the heart was inhibited by the tricyclic drug, imipramine, and this agent also accelerated the rate of loss of [¹²³I]MIBG. Phenylpropanolamine, a sympathomimetic drug that acts by displacing norepinephrine from neurons, increased the rates of loss of [¹²³I]MIBG from the heart. Exercise was followed by a movement of [¹²³I]MIBG into blood and urine. Generalized autonomic neuropathies were associated with marked diminutions of [¹²³I]MIBG uptake into the heart. We conclude that quantitative scintigraphy in patients will enable determinations of regional disturbances in integrity (by measuring uptake of [¹²³I]MIBG) and function (by measuring rates of loss of [¹²³I]MIBG) of the adrenergic nervous system in the heart.

FOOTNOTES

^* Present address: Veterans Administration Medical Center, P.O. Box 1034, Portland, OR 97207.

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