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Nuklearmedizin 2013; 52(06): 228-234
DOI: 10.3413/Nukmed-0590-13-05
Original article
Schattauer GmbH

Catecholamines influence myocardial 123I MIBG uptake in neuroblastoma patients

Katecholamine beeinflussen die myokardiale 123I-MIBG-Aufnahme in Neuroblastom-Patienten
R. L. F. van der Palen
1   Department of Paediatric Haematology and Oncology, Radboud University Nijmegen Medical Centre, The Netherlands
2   Department of Paediatric Cardiology, Academic Medical Center, University of Amsterdam, The Netherlands
,
B. F. Bulten
3   Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, The Netherlands
,
A. M. C. Mavinkurve-Groothuis
1   Department of Paediatric Haematology and Oncology, Radboud University Nijmegen Medical Centre, The Netherlands
,
L. Bellersen
4   Department of Cardiology, Radboud University Nijmegen Medical Centre, The Netherlands
,
H. W. M. van Laarhoven
5   Department of Medical Oncology, Radboud University Nijmegen Medical Centre, The Netherlands
6   Department of Medical Oncology, Academic Medical Center, University of Amsterdam, The Netherlands
,
L. Kapusta
7   Children’s Heart Centre, Radboud University Nijmegen Medical Centre, The Netherlands
8   Paediatric Cardiology Unit, Edith Wolfson Medical Center, Holon, Israel
,
L. F. de Geus-Oei
3   Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, The Netherlands
› Author Affiliations
Further Information

Publication History

received: 20 May 2013

accepted in revised form: 03 September 2013

Publication Date:
12 January 2018 (online)

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Summary

Aim: Cardiac 123I metaiodobenzylguanidine (MIBG) imaging can be influenced by several factors. We evaluated the relationship between catecholamine measurements and cardiac 123I MIBG uptake in neuroblastoma patients. Patients, methods: 30 neuroblastoma patients were retrospectively assessed on cardiac 123I MIBG uptake and urinary catecholamine dopamine and metabolites, homovanillic acid (HVA) and vanillylmandelic acid (VMA). Cardiac 123I MIBG uptake was quantified by heart-to-mediastinum (H/M) ratios, which were calculated into standard deviation scores (SDS) using age-specific reference values. Results: In 17 (57%) and 12 patients (40%) H/M ratio measurements were below –1.0 and –2.0 SDS at diagnosis. A significant inverse correlation between the average of urine metabolites HVA and VMA, and H/M ratio SDS was observed (r -.39, p = 0.04). Furthermore, there was a significant correlation between the urinary catecholamine metabolite HVA and H/M ratio SDS (r -.40, p = 0.04). Conclusion: Routine calculation of H/M ratios in 123I MIBG scintigrams of neuroblastoma patients is not helpful because it will not identify cardiac ventricular dysfunction in this patient category. A low H/M ratio on 123I MIBG scintigraphy is explained by increased cathecholamine levels secreted by neuroblastoma tumours.

Zusammenfassung

Ziel: Myokardiale 123I-Metaiodbenzylguanidin-( MIBG)-Szintigraphie kann durch verschiedene Faktoren beeinflusst werden. Wir untersuchten die Beziehung zwischen der Menge von Katecholaminen und myokardialer 123I-MIBG-Aufnahme bei Neuroblastom-Patienten. Patienten, Methoden: Bei 30 Neuroblastom- Patienten wurden retrospektiv eine myokardiale 123I-MIBG-Aufnahme sowie das Katecholamin Dopamin und dessen Metaboliten, Homovanillinsäure (HVA) und Vanillinmandelsäure (VMA) im Urin beurteilt. Die myokardiale 123I-MIBG-Aufnahme wurde mit dem Herz-/Mediastinum (H/M)-Quotienten quantifiziert und mit altersspezifischen Referenzwerten als Z-Score-Wert (SDS) ausgedrückt. Ergebnisse: Bei 17 (57%) Patienten war der H/M-Quotient unter –1.0 und bei 12 Patienten (40%) unter –2.0 SDS bei Diagnosestellung. Er wurde sowohl eine inverse Korrelation zwischen der durchschnittlichen Menge der Urin-Katecholamin-Metaboliten HVA und VMA und dem H/M-Quotienten SDS (r – .39, p = 0,04) als auch eine inverse Korrelation zwischen dem Urin-Katecholamine HVA und dem H/M-Quotienten SDS (r -.40, p = 0.04) beobachtet. Schlussfolgerung: Als Routineanalyse wird der H/M-Quotient eines myokardialen 123I-MIBG-Szintigramms in Neuroblastom-Patienten nicht empfohlen, weil es eine kardiale Dysfunktion zum Zeitpunkt der Diagnose nicht identifizieren kann. Ein niedriger H/M-Quotient eines 123I-MIBGSzintigramms wird durch die erhöhte Katecholaminausschüttung des Neuroblastom- Tumors verursacht.

Keywords

Metaiodobenzylguanidine - neuroblastoma - catecholamine - cardiac imaging

Schlüsselwörter

Metaiodbenzylguanidin - Neuroblastom - Katecholamine - Herzdiagnostik
 

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