¹²³I-α-Methyltyrosin-Szintigraphie beim malignen Melanom

Zusammenfassung

Ziel: Ziel der Studie war es, die Wertigkeit der Szintigraphie mit L-3-¹²³I-α-Methyltyrosin (¹²³I-AMT) beim metastasierenden Melanom zu untersuchen. Methoden: 26 Metastasen und ein Primärtumor eines malignen Melanoms bei sechs Patienten wurden mit einer ¹²³I-AMT-Ganz-körperszintigraphie und SPECT untersucht. Als Referenzmethode lag eine Positronen-Emissions-Tomographie mit 2-¹⁸F-Fluor-2-desoxy-D-gluco-se (¹⁸F-FDG) vor. Ergebnisse: Mit ¹²³I-AMT-SPECT ließen sich 8/10 Thoraxmetastasen mit einem Durchmesser >1,6 cm nachweisen (Ratio T/NT 1,2-1,8), Metastasen <1,6 cm ließen sich in der SPECT nicht darstellen. In der ¹²³I-AMT-Ganzkörperszintigraphie fand sich bei keinem Herd eine positive Tumoranreicherung. Schlußfolgerung: In Einzelfällen kann die ¹²³I-AMT-Szintigraphie beim Staging des malignen Melanoms hilfreich sein.

Summary

Aim: The aim of the study was to evaluate the ranking of the scintigraphy with L-3-¹²³I-α-methyl tyrosine (¹²³I-AMT) in metastised melanoma. Methods: 26 metastases and one primary tumor of a malignant melanoma in six patients were examined with ¹²³I-AMT whole-body scintigraphy and SPECT. Positron Emission Tomography with 2-¹⁸F-fluoro-2-desoxy-D-glucose (¹⁸F-FDG) was used as the golden standard. Results: With ¹²³I-AMT-SPECT 8/10 metastases in the thorax >1,6 cm were detected (ratio T/NT 1,2-1,8), metastases <1,6 cm were not detectable with SPECT. In ¹²³I-AMT whole-body scintigraphy not one lesion showed a positive tumor uptake. Conclusion: In single cases ¹²³I-AMT scintigraphy can be helpful in staging of malignant melanoma.

Schlüsselwörter

Melanom - α-Methyltyrosin - ¹²³I-AMT

Keywords

Melanoma - α-methyl tyrosine - ¹²³I-AMT

• LITERATUR

• 1 Bekerman C, Hoffer PB, Bitran JD. The role of Gallium-67 in the clinical evaluation of cancer. Sem Nucl Med 1985; 15: 72-103.
• 2 Biersack HJ, Coenen HH, Stöcklin G. et al. Imaging of brain tumors with L-3-[¹²³I]Iodo-α-Methyl Tyrosine and SPECT. J Nucl Med 1989; 30: 110-2.
• 3 Bockisch A, Oehr P, Biltz H, Hotze A, Kreysel HW, Biersack HJ. The clinical value of radioimmunodetection (RID) using anti-melanoma antibodies. Tumordiag u Ther 1991; 12: 112-6.
• 4 Bockslaff H, Kloster G, Dausch D, Schad K, Hundeshagen H, Stöcklin G. First clinical results using L-3-¹²³I-α-Methyltyrosine for the non-invasive detection of intraocular melanomas. In: Nuklearmedizin. Schmidt HA, Wolf F, Mahlstedt J. (Hrsg). Stuttgart, New York: Schattauer; 1981: 840-4.
• 5 Böni R, Huch Böni RA, Steinen H. et al. Staging of metastatic melanoma by whole-body positron emission tomography (PET) using 2-fluorine-18-fluoro-2-deoxy-D-gluco-se. Br J Dermatol 1995; 132: 556-62.
• 6 Böni R, Huch Böni RA, Steinen H. et al. Antimelanoma monoclonal antibody 225.28S immunoscintigraphy in metastatic melanoma. Dermatology 1995; 191: 119-23.
• 7 Brandau W, Kirchner B, Bartenstein P, Sciuk J, Kamanabrou D, Schober O. N-(2-diethyl-aminoethyl)-4-[¹²³I]iodobenzamide as a tracer for the detection of malignant melanoma: simple synthesis, improved labelling technique and first clinical results. Eur J Nucl Med 1993; 20: 238-43.
• 8 Brozena SJ, Fenske NA, Perez IR. Epidemiology of malignant melanoma, worldwide incidence, and etiologic factors. Sem Surg Oncol 1993; 9: 165-7.
• 9 Bubeck B, Eisenhut M, Heimke U, zum Winkel K. Melanoma affine radiopharmaceuticals. Eur J Nucl Med 1981; 6: 227-33.
• 10 Fimian WJ, Dowd GA. Quantitative determination of C14-tyrosine absorption in me-lanated and non-melanated mouse tissues. Proc Soc Exptl Biol Med 1959; 102: 95-7.
• 11 Gritters LS, Francis IR, Zasadny KR, Wahl RL. Initial assessment of positron emission tomography using 2-flurine-18-fluoro-2-deoxy-D-glucose in the imaging of malignant melanoma. J Nucl Med 1993; 34: 1420-7.
• 12 Guth-Tougelidis B, Müller St, Mehdorn MM, Knust EJ, Dutschka K, Reiners Chr. Anreicherung von DL-3-¹²³I-Jod-α-Methyl-tyrosin in Hirntumorrezidiven. Nuklearmedizin 1995; 34: 71-5.
• 13 Hoefnagel CA, Rankin EM, Valdes Olmos RA, Israels SP, Pavel S, Janssen AGM. Sensitivity versus specifity in melanoma using iodine-123 iodobenzamide and indium-111 pentetreotide. Eur J Nucl Med 1994; 21: 587-8.
• 14 Ishiwata K, Kubota K, Kubota R, Iwata R, Takahashi T, and Ido T. Selective 2-[¹⁸F] fluorodopa uptake for melanogenesis in murine metastatic melanomas. J Nucl Med 1991; 32: 95-101.
• 15 Jimbow K, Iwashina T, Alena F, Yamada K, Pankovich J, Umemura T. Exploitation of pigment biosynthesis pathway as a selective chemotherapeutic approach for malignant melanoma. J Invest Dermatol 1993; 100: 231-8S.
• 16 Kloss G, Leven M. Accumulation of radio-iodinated tyrosine derivatives in the adrenal medulla and in melanomas. Eur J Nucl Med 1979; 4: 179-86.
• 17 Kloster G, Bockslaff H. L-3-¹²³I-alpha-me-thyltyrosine for melanoma detection: a comparative evaluation. Int J Nucl Med Biol 1982; 9: 259-69.
• 18 Langen KJ, Coenen HH, Roosen N. et al. SPECT studies of brain tumors with L-3-[¹²³I]iodo-α-methyl tyrosine: Comparison with PET, 123IMT and first clinical results. J Nucl Med 1990; 31: 281-6.
• 19 Langen KJ, Roosen N, Coenen HH. et al. Brain and brain tumor uptake of L-3-[¹²³I]iodo-α-methyl tyrosine: Competition with natural L-amino-acids. J Nucl Med 1991; 32: 1225-8.
• 20 Langevelde van A, Bakker CNM, Boer H. et al. Potential radiopharmaceuticals for the detection of ocular melanoma. Iodoquinoli-ne derivatives and ⁶⁷Ga-citrate. Eur J Nucl Med 1986; 12: 96-104.
• 21 Langevelde van A, Molen van der HD, Journée-de Korver JG, Paans AMJ, Pauwels EKJ, Vaalburg W. Potential radiopharmaceuticals for the detection of ocular melanoma. Part III. A study with ¹⁴C and ¹¹C labelled tyrosine and dihydroxyphenylalani-ne. Eur J Nucl Med 1988; 14: 382-7.
• 22 Lindholm P, Leskinen S, Någren K. et al. Car-bon-11-methionine PET imaging of malignant melanoma. J Nucl Med 1995; 36: 1806-10.
• 23 Maffioli L, Mascheroni L, Monioj V. et al. Scintigraphic detection of melanoma metastases with a radiolabeled benzamide ([I-123]-(S)-IBZM). J Nucl Med 1994; 35: 1741-7.
• 24 Meier DA, Beierwaltes WH, Counsell RE. Radioactivity from labeled precursors of melanin in mice and hamsters with melanomas. Cancer Res 1967; 27: 1354-9.
• 25 Michelot JM, Moreau MFC, Veyre AJ. et al. Phase II scintigraphic clinical trial of malignant melanoma and metastases with iodine-123-N-(2-diethylaminoethyl 4-iodobenzami-de). J Nucl Med 1993; 34: 1260-6.
• 26 Pounds TR, Valk PE, Haseman MK. et al. Whole-body PET-FDG imaging in diagnosis of metastatic melanoma: Comparison to CT. J Nucl Med 1995; 36: 116P.
• 27 Schober O, Wagner W, Assmann S. et al. Transfer from PET to SPECT: The assessment of ¹²³I-α-Methyltyrosine (IMT) in recurrence of primary brain tumors. J Nucl Med 1994; 35: 9P.
• 28 Steinen H, Huch Böni RA, Buck A. et al. Malignant melanoma: Staging with Whole-Body Positron Emission Tomography and 2-[¹⁸F]-fluoro-2-deoxy-D-glucose. Radiology 1995; 195: 705-9.
• 29 Udenfried S, Zaltzmann-Nirenberg PTN. Inhibitors of purified beef adrenal tyrosine hydroxylase. Biochem Pharmacol 1965; 14: 837-45.
• 30 Westera G, Böni R, Meyer J, Huch Böni R, Steinert H. ¹²³I-Iodomethyltyrosine (123-1-IMT): a simplified preparation and metabolite analysis. Journal of labelled compounds and radiopharmaceuticals 1995; 30: 158.
• 31 Wunderlich G, Schmidt D, Langen KJ. et al. Evaluation of chemotherapy in gliomas by I-123-α-Methyltyrosin SPECT: first results. Eur J Nucl Med 1995; 22: 796.
• 32 Yao WJ, Höh CK, Glaspy JA. et al. Whole Body FDG PET imaging for staging of malignant melanoma: Is it cost effective?. J Nucl Med 1994; 35: 8P.