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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



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FIGURE 1. 123I-MIBG scintigrams (left, anterior image; right, posterior image) of 4-y-old boy who had been treated for neuroblastoma show string-like accumulations on bilateral nape of neck (arrows). Subsequent studies, including CT and tumor markers, failed to detect any evidence of tumors at same site.

 


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FIGURE 2. 123I-MIBG scintigrams obtained in February (A) and follow-up study obtained in August (B) (same case as in Fig. 1). Accumulation observed in winter (arrows) disappeared in summer. Patient had not undergone any treatment between examinations.

 


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FIGURE 3. 123I-MIBG scintigrams. (A) Whole-body scan. (B) SPECT sagittal image (upper) and SPECT coronal image (lower) of 2-y-old boy, who had suffered from Horner’s syndrome after operation for tumor originating in thoracic sympathetic nervous trunk. There is laterality in accumulation in chest. SPECT demonstrated apparent nape-of-neck accumulation only on right (healthy) side (arrows).

 


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FIGURE 4. 123I-MIBG scintigram (A) of 3-y-old girl and her thermogram (B). Distribution of nape-of-neck accumulation resembles distribution of relatively high body temperature (arrows).

 





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