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Normal cerebellar MIBG localization. Implications in the interpretation of delayed scans
R S Hattner1, T R Pounds, K K Matthay
1Department of Radiology (Nuclear Medicine), School of Medicine, University of California San Francisco.
Clinical Nuclear Medicine
|November 1, 1994
Summary
Delayed Iodine-131 MIBG scans in neuroblastoma patients often show cerebellar uptake. This normal finding, related to central nervous system catecholamine receptors, should not be mistaken for cancer spread.
Area of Science:
- Nuclear Medicine
- Oncology
- Radiopharmaceuticals
Background:
- Iodine-131 meta-iodobenzylguanidine (MIBG) scans are used to diagnose and stage neuroblastoma and other neuroendocrine tumors.
- Cerebellar uptake of MIBG in delayed scans has been observed, but its significance is not always clear.
Purpose of the Study:
- To determine if cerebellar MIBG localization in delayed scans is a normal finding in patients with adrenergic neuronal neoplasms.
- To differentiate normal cerebellar uptake from potential neuraxial metastasis.
Main Methods:
- Retrospective analysis of I-131 MIBG scans from 14 patients with neuroblastoma or pheochromocytoma/paraganglioma.
- Scans were evaluated more than 48 hours after radiopharmaceutical administration.
Main Results:
- 12 out of 14 patients (86%) showed discernible cerebellar MIBG localization on delayed scans.
- Some patients also exhibited midbrain or diffuse cerebral uptake.
- No patients had clinical signs or symptoms of central nervous system involvement.
Conclusions:
- Cerebellar MIBG localization on delayed scans is likely a normal finding in patients with adrenergic neuronal neoplasms.
- This uptake pattern is consistent with the distribution of central nervous system catecholamine receptors.
- Delayed cerebellar MIBG uptake should not be misinterpreted as neuraxial metastasis.