Carcinoid tumors: iodine-131 MIBG scintigraphy

Eighty-two patients with pathologically proved carcinoid tumors were examined with iodine-131 metaio-dobenzylguanidine (MIBG) scintigraphy. Localization scores of I-131 MIBG accumulation in the primary tumor or metastatic site ranged from 0 to 3+ on the basis of comparison with normal liver. I-131 MIBG uptake varied greatly in different patients with carcinoid tumors. The localization scores in known tumor sites were related to the location of the primary tumor in the stomach (1-3+ in two of five patients), pancreas (1-3+ in four of five patients), cecum (3+ in two of two patients), appendix (0 in one of one patient), jejunum (0 in one of one patient), Meckel diverticulum (3+ in one of one patient), terminal ileum (2-3+ in 19 of 28 patients), bronchus (3+ in one of nine patients), thymus (1+ in one of two patients), and unknown (2-3+ in 18 of 28 patients). Tumors of midgut origin concentrated I-131 MIBG more frequently than those of foregut origin. Uptake of I-131 MIBG was more likely if neurohumor levels, particularly serum serotonin, were elevated. There was no relationship of I-131 MIBG uptake to carcinoid syndrome. I-131 MIBG is useful in the determination of the location and extent of some carcinoid tumors, particularly those of midgut origin.