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Radiopharmaceuticals for Diagnostics
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Jim Ballinger, Jacek Koziorowski
Imaging the adrenal glands is difficult because they are so close to the kidneys. In the early 1980s the tracer 123I-iobenguane (metaiodobenzylguanidine, MIBG, Adreview) was developed and remains the agent of choice. Iobenguane is an analogue of noradrenaline and is taken up by the noradrenaline transporter and stored in presynaptic vesicles. Whole-body and SPECT images are obtained 24 h after injection [36]. Adrenergic tumours include pheochromacytoma, carcinoid tumour, and neuroblastoma (particularly paediatric). High activities of 131I-iobenguane can be used to treat certain adrenergic tumours.
Sex differences in 123I-mIBG scintigraphy imaging techniques in patients with heart failure
Published in Expert Review of Medical Devices, 2023
Miriam Conte, Maria Silvia De Feo, Viviana Frantellizzi, Arianna Di Rocco, Alessio Farcomeni, Flaminia De Cristofaro, Ricci Maria, Antonio Rosario Pisani, Giuseppe Rubini, Giuseppe De Vincentis
Meta-iodobenzylguanidine (mIBG), also known as Iobenguane, is a noradrenaline analog and it is considered a ‘false’ neurotransmitter since it is an aralkylguanidine derived from the combination of the benzyl group of bretylium, an antiarrhythmic drug, and the guanidine group of guanethidine, an adrenergic neuron blocker [1]. This molecule is taken up by presynaptic sympathetic nerve endings via sodium- and ATP-dependent ‘uptake-1’ mechanism and, differently from norepinephrine, it is not metabolized. It accumulates physiologically in neurosecretory vesicles of all tissues with adrenergic innervation such as the myocardium, salivary glands, and adrenal medulla. The possible applications of mIBG in nuclear medicine could range from oncological treatment and endocrinology to neurology and cardiology: mIBG labeled with 131I is a radiotherapeutic metabolic agent in neuroectodermal malignancies [1,2]; when it is labeled with 123I, it could be used to discriminate Parkinson’s Disease (PD) and Multiple System Atrophy (MSA) through the identification of cardiac postganglionic autonomic involvement, since cardiac uptake is possible if only postganglionic sympathetic neurons are undamaged. This phenomenon is typical in MSA which has a preganglionic autonomic failure [3–5]; 123I-mIBG finds application in the detection of phaeochromocytomas, paragangliomas, and neuroblastomas but could also be used in carcinoids, medullary thyroid carcinomas and nonfunctioning paragangliomas [6,7]. In cardiology, 123I-mIBG main indication is for the evaluation of patients with a diagnosis of heart failure (HF) [8,9]. In this paper, the application of 123I-mIBG in patients with HFrEF has been analyzed and viable solutions for the acquisition protocols have been proposed. Nowadays, no studies sex-based have been conducted to evaluate the difference between males and women with HF in terms of the prediction of cardiac arrhythmic events (AE). In the following paragraphs, a review of the possible role of mIBG in HF will be explained, and the study conducted will be presented.