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Journal of Nuclear Medicine Vol. 44 No. 9 1421-1425
© 2003 by Society of Nuclear Medicine

Clinical Investigations

123I-Metaiodobenzylguanidine Uptake in the Nape of the Neck of Children: Likely Visualization of Brown Adipose Tissue

Chio Okuyama, MD, PhD1, Yo Ushijima, MD, PhD1, Takao Kubota, MD1, Toshihide Yoshida, MD, PhD2, Takako Nakai, MD1, Kana Kobayashi, MD1 and Tsunehiko Nishimura, MD, PhD1

1 Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
2 First Department of Internal Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

The distribution of radioiodinated metaiodobenzylguanidine (MIBG) has been studied primarily in patients with neuroendocrine tumors—in pediatrics, particularly with neuroblastomas. Sometimes, symmetric accumulation in which no tumor is identified is seen in the nape-of-the-neck region. We estimated visually whether accumulation was found in the nape of the neck and studied the characteristics of the accumulation. Methods: Retrospectively, we investigated 266 123I-MIBG scintigraphic studies performed on pediatric patients who had been treated for neuroendocrine tumors or who were suspected of having such tumors. Results: Accumulation in the nape of the neck was seen in 32 of 266 studies (12%); in none of these cases was the accumulation identified as a tumor by other imaging modalities or follow-up studies. In the same individuals, the accumulation varied and it was observed more often during winter. Conclusion: Symmetric 123I-MIBG accumulations in the nape-of-the-neck region observed in children are thought to be related to the uptake in brown adipose tissue.

Key Words: 123I-metaiodobenzylguanidine • neuroendocrine tumor • brown adipose tissue • nape-of-the-neck accumulation • children




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