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Beat-to-Beat QT Interval Variability and Autonomic Activity
Published in Herbert F. Jelinek, David J. Cornforth, Ahsan H. Khandoker, ECG Time Series Variability Analysis, 2017
Cardiac imaging using (123I-MIBG) scintigraphy allows quantification of sympathetic innervation of the heart. 123I-MIBG is taken up by sympathetic neurons due to its similarity to the noradrenaline molecule and can be observed with single photon emission computed tomography (SPECT). A reduction in cardiac 123I-MIBG uptake is due to low ventricular β1-adrenoreceptor density and∕or noradrenaline uptake, indicative of sympathetic dysinnervation.
Endocrine system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Radionuclide imaging: PET–CT is valuable in staging lung cancer, and will detect adrenal metastases even if very small. It is also recommended for imaging adrenal masses found in patients known to have cancer, as part of the assessment of a potential incidental mass in this situation [7]. It may also form part of the staging protocol for primary adrenal malignancy, including PCC. Functional imaging using MIBG (131I-metaiodobenzylguanidine) is useful in the assessment, staging and follow-up of PCC. It is less sensitive than CT or MRI, but more specific for this particular tumour.
Machine Learning Approach to Overcome the Challenges in Theranostics
Published in Shampa Sen, Leonid Datta, Sayak Mitra, Machine Learning and IoT, 2018
Bishwambhar Mishra, Sayak Mitra, Karthikeya Srinivasa Varma Gottimukkala, Shampa Sen
I-131 labeled meta-iodobenzylguanidine (mIBG) has been used for many years in the treatment of adult and pediatric neuroendocrine tumors (including phaeochromocytoma, paraganglioma, and neuroblastoma), typically with administrations of 7.4 GBq to more than 30 GBq in adults. To treat cancer, several monoclonal antibodies have been developed.
Theranostic approaches in nuclear medicine: current status and future prospects
Published in Expert Review of Medical Devices, 2020
Luca Filippi, Agostino Chiaravalloti, Orazio Schillaci, Roberto Cianni, Oreste Bagni
MIBG represents a radiopharmaceutical with clear theranostic implications, since it can be labeled both with 123I (for diagnosis) and 131I (for therapy). In patient candidate for treatment with 131I-MIBG, the pre-therapeutic imaging with 123I-MIBG plays the crucial role of demonstrating in vivo the avidity of NB for the radioligand. Of note, the biodistribution of the two radiotracers is almost identical with the exception of cerebellar uptake which was noted only for 131I-MIBG and not for 123I-MIBG [30]. Although 131I-MIBG was also used for the treatment of adult pheocromocytomas and paragangliomas, 131I-MIBG as a single agent or in combination with other drugs plays a major role for the treatment of children affected by relapsed or chemorefractory NB with response rate between 20% and 40% [31,32]. 131I-MIBG was also successfully introduced as front-line therapy for the down-sizing of NB: a group of 44 patients affected by high-risk NB was administered with at least 2 cycles of 131I-MIBG with a fixed dose of 7.4 and 3.7 GBq, respectively, and then followed by surgery, if feasible, or by neoadjuvant chemotherapy and surgery, with an overall response rate of 73% [33].
Nuclear Medicine in Oncology
Published in Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization, 2018
Carla Oliveira, Rui Parafita, Ana Canudo, Joana Correia Castanheira, Durval C. Costa
The neuroendocrine system of the sympathetic-adrenal axis is derived from cells originating in the neuroectoderm. Its cells are characterised by the ability to take up amine precursors with a subsequent transformation into catecholamines, which are stored in cytoplasmic chromaffin granules. Therefore, the use of a radiopharmaceutical that is a guanethidine analogue, which is taken up and stored in the chromaffin granules – 123I-metaiodobenzylguanidine (MIBG) – allows for the scintigraphic visualisation of tumours in the sympathetic-adrenal system (pheochromocytomas, paragangliomas and neuroblastomas) and its metastases (as well as any other tumours that present an accentuated uptake of the radiopharmaceutical, namely the medullary thyroid carcinoma). The scintigraphy with 123I-MIBG is, consequently, advised to (re)stage and appraise the response to treatment in these tumours and to detect the primary tumour (emphasising its high level of specificity, at about 95–100%, to detect pheochromocytoma). Also, as the treatment with 131I-MIBG can be indicated in some of these cases (the beta emitter 131I linked to MIBG permits the destruction of the neoplastic cells with the ability to concentrate catecholamines), the scintigraphy with 123I-MIBG is used to select patients for this treatment (the potential candidates are those who present an intense uptake of the radiopharmaceutical by the tumour and its metastases).