Abstract
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. Conclusion: 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.
- 3-iodobenzylguanidine
- iodine radioisotopes
- neuroendocrine tumors
- radioisotope therapy
- intraarterial infusions
Footnotes
Received Apr. 30, 2005; revision accepted Aug. 11, 2005.
For correspondence or reprints contact: Claudia Brogsitter, MD, Department of Nuclear Medicine, University of Dresden, Fetscherstrasse 74, 01307 Dresden, Germany.
E-mail: Claudia.Brogsitter{at}uniklinikum-dresden.de