Clinical Application of SPECT in Adrenal Imaging with lodine-131 6??-lodomethyl-19-Norcholesterol

Ishimura, Junji; Kawanaka, Masahiro; Fukuchi, Minoru

doi:10.1097/00003072-198904000-00009

Cited by 14 publications

(6 citation statements)

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“…In prelim-inary results using SPECT by a standard method, uptake in 68 detectable glands ranged from 1.7% to 4.9% in four glands with Cushing's syndrome, from 1.1% to 1.3% in seven glands with primary aldosteronism, and were distributed below 1.0% in the remaining glands with normally functioning adrenal cortices. All of these results show that it is possible to evaluate the adrenocortical functioning atatus simply by analyzing the SPECT images of the adrenal (15).…”

Section: Commentsmentioning

confidence: 78%

“…Forty-one patients with or without adrenocortical disorders were studied to evaluate the clinical usefulness of SPECT in adrenal imaging with 131 I-6b e t a -i o d o m e t h y l -1 9 -n o r c h o l e s t e r o l (15). In the SPECT images from this study, all glands with either normally functioning or hyperfunctioning adrenal cortices could be detected, while those glands with hypofunctioning adrenal cortices could not be detected.…”

Section: Commentsmentioning

confidence: 99%

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Adrenocortical Scintigraphy with 131I-6-Beta-Iodomethyl-NorchoIesterol (NP 59) in Bilateral Adrenocortical Carcinoma

Hernández

Pallarés²,

Bartual³

et al. 1998

Nuklearmedizin

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Section: Commentsmentioning

confidence: 78%

Section: Commentsmentioning

confidence: 99%

Adrenocortical Scintigraphy with 131I-6-Beta-Iodomethyl-NorchoIesterol (NP 59) in Bilateral Adrenocortical Carcinoma

Hernández

Pallarés²,

Bartual³

et al. 1998

Nuklearmedizin

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“…This deficiency may be remedied by SPECT, which bears better contrast and improves image resolution. NP-59 SPECT has been suggested to be useful in evaluating the functional status of adrenal cortical lesions (27,28). Nevertheless, the lack of anatomic landmarks may cause gastrointestinal or gallbladder activity to be misinterpreted as hyperfunctioning adrenal adenoma.…”

Section: Discussionmentioning

confidence: 99%

¹³¹I-6β-Iodomethyl-19-Norcholesterol SPECT/CT for Primary Aldosteronism Patients with Inconclusive Adrenal Venous Sampling and CT Results

Yen¹,

Wu²,

Liu³

et al. 2009

J Nucl Med

103

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The 2 main causes of primary aldosteronism (PA) are aldosteroneproducing adenoma (APA) and idiopathic adrenal hyperplasia (IAH). Dexamethasone-suppression 131 I-6b-iodomethyl-19-norcholesterol (NP-59) adrenal scintigraphy can assess the functioning of the adrenal cortex. This study evaluated the diagnostic usefulness of NP-59 SPECT/CT in differentiating APA from IAH and in predicting postadrenalectomy clinical outcome for PA patients who had inconclusive adrenal venous sampling (AVS) and CT results. Methods: We retrospectively reviewed the 31 adrenal lesions of 27 patients (age range, 33-71 y; mean age 6 SD, 50.4 6 10.9 y) who had been clinically confirmed (by saline infusion and captopril tests) to have PA, had inconclusive CT and AVS test results, and had undergone NP-59 imaging before adrenalectomy. The accuracy of NP-59 imaging was determined by comparison with histopathologic findings. Results: NP-59 SPECT/ CT gave us 18 true-positive, 3 false-positive, 6 true-negative, and 4 false-negative results. Compared with planar imaging, SPECT/CT significantly improved diagnostic accuracy and prognostic predicting ability (P 5 0.0390 and P 5 0.0141, respectively). The NP-59 results were negative for 7 of the 23 patients with unilateral adrenal lesions, and none of these 7 patients had shown postsurgical clinical improvement. Conclusion: NP-59 SPECT/CT is an effective imaging tool for differentiating APA from IAH in PA patients whose CT and AVS results are inconclusive. Our results suggest that patients with presurgically negative NP-59 results should be treated medically and that noninvasive NP-59 SPECT/CT may be suited for use as the first lateralization modality after CT in patients with clinically confirmed PA.

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“…Baseline imaging (without hormonal manipulation) is usually obtained by planar scans of the abdomen 5 days after tracer administration; further imaging on days 6-7 (until day 14 with Scintadren) can be obtained, especially in cases with relatively high interfering bowel background activity (15). Single photon emission computed tomography (SPECT) acquisition has been suggested to be useful in some cases (16). In some pathologies, such as primary hyperaldosteronism and masculinising or feminising adrenal tumours, baseline NCL-6-I imaging has poor sensitivity due to the overlapping uptake of the adrenocorticotrophin (ACTH)-dependent normal adrenal tissue of the inner zones which can mask the uptake of a relatively small tumour (generally the size of Conn's tumour is less than 2 cm) (17).…”

Section: Patient Preparation and Ncl-6-i Scintigraphic Techniquementioning

confidence: 99%

Functional scintigraphy of the adrenal gland

et al. 2002

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Over the last 30 years nuclear medicine imaging of the adrenal gland and its lesions has been achieved by the exploitation of a number of physiological characteristics of this organ. By seeking and utilising features which are quantitatively or qualitatively different from those of the adjacent tissues, functional depiction of the adrenal gland and its diseases, which in most cases retain the basic physiology of their tissue of origin, including both the cortex and the medulla, are now a useful clinical reality. Agents widely used in clinical practice include: (a) uptake and storage of radiolabelled cholesterol analogues via the low density lipoprotein (LDL) receptor and cholesterol ester storage pool in the adrenal cortex ( 131 I-6-b-iodomethyl-norcholesterol, 75 Se-selenomethyl-norcholesterol); (b) catecholamine type I, presynaptic, uptake mechanism and intracellular granule uptake and storage mechanism in the adrenal medulla and extra-adrenal paraganglia ( 131 I-, 123 I-and 124 Imeta-iodo-benzyl-guanidine (MIBG), 18 F-metafluoro-benzyl-guanidine); (c) cell surface receptor binding of peptides/neurotransmitters/modulators such as for the family of five subtypes of somatostatin receptors ( 123 I-tyr-octreotide, 111 In-DTPA-octreotide, 111 In-DOTA-octreotide and many others); (d) although not specific for the adrenal gland, increased glycolysis by tumours, particularly the most malignant varieties, 18 F-2-fluoro-D-deoxyglucose can thus be expected to depict certain malignant lesions such as malignant pheochromocytomas (particularly the minority which are not detected by MIBG) and adrenal incidentalomas (particularly when they occur in patients with known extraadrenal malignancies). There are a variety of adrenal tissue characteristics with potential for exploitation but which are not currently in clinical use, and which may, nevertheless, have potential as imaging agents. These include: (a) inhibitors of adrenal cortical steroid hormone synthesis enzymes (e.g. radiolabelled analogues of metyrapone); (b) radiolabelled lipoproteins which bind to adrenocortical LDL receptors; (c) inhibitors of catecholamine biosynthesis enzymes (e.g. radiolabelled analogues of tyrosine and related amino acids); (d) cell surface receptors for various peptides and hormones which may be overexpressed on adrenal cortical or adrenal medullary tumours (e.g. radiolabelled analogues of ACTH on adrenocortical cells of zona fasciculata or zona glomerulosa origin, neurotransmitter/hormone message peptides binding to cell surface receptors such as bombesin, vasoactive intestinal polypeptide, cholecystokinin and opiate peptides); (e) the adrenal cortex can also synthesise cholesterol ab initio from acetate, and preliminary studies with 11 C-acetate positron emission tomography have shown interesting results. European Journal of Endocrinology 147 13-28 Adrenal cortexThe adrenal cortex is constituted of three layers. The outer layer, the glomerulosa zone, produces mineralocorticoids (mainly aldosterone) under the control of the renin -a...

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Clinical Application of SPECT in Adrenal Imaging with lodine-131 6??-lodomethyl-19-Norcholesterol

Cited by 14 publications

References 0 publications

Adrenocortical Scintigraphy with 131I-6-Beta-Iodomethyl-NorchoIesterol (NP 59) in Bilateral Adrenocortical Carcinoma

Adrenocortical Scintigraphy with 131I-6-Beta-Iodomethyl-NorchoIesterol (NP 59) in Bilateral Adrenocortical Carcinoma

¹³¹I-6β-Iodomethyl-19-Norcholesterol SPECT/CT for Primary Aldosteronism Patients with Inconclusive Adrenal Venous Sampling and CT Results

Functional scintigraphy of the adrenal gland

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Clinical Application of SPECT in Adrenal Imaging with lodine-131 6??-lodomethyl-19-Norcholesterol

Cited by 14 publications

References 0 publications

Adrenocortical Scintigraphy with 131I-6-Beta-Iodomethyl-NorchoIesterol (NP 59) in Bilateral Adrenocortical Carcinoma

Adrenocortical Scintigraphy with 131I-6-Beta-Iodomethyl-NorchoIesterol (NP 59) in Bilateral Adrenocortical Carcinoma

131I-6β-Iodomethyl-19-Norcholesterol SPECT/CT for Primary Aldosteronism Patients with Inconclusive Adrenal Venous Sampling and CT Results

Functional scintigraphy of the adrenal gland

Contact Info

Product

Resources

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¹³¹I-6β-Iodomethyl-19-Norcholesterol SPECT/CT for Primary Aldosteronism Patients with Inconclusive Adrenal Venous Sampling and CT Results