Document Detail


Routine preoperative (123)I-MIBG scintigraphy for patients with phaeochromocytoma is not necessary.
MedLine Citation:
PMID:  18663465     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Functional imaging using (123)I-meta-iodo-benzyl-guanetidine (MIBG) scintigraphy has alleged 100% specificity for phaeochromocytoma (PHAEO). Its benefit in patients with biochemical diagnosis of PHAEO is arguable when cross-sectional radiology can demonstrate the side-size of the adrenal tumours. MATERIALS AND METHODS: This is a retrospective review of clinical notes of patients undergoing adrenalectomy for PHAEO in a University centre. RESULTS: Between January 2000 and December 2007, adrenalectomy for PHAEO was performed on 66 patients (28 M and 38 F, aged 24-82 years). Diagnosis was demonstrated by raised 24-h urine catecholamines (n = 14) or metanephrines (n = 52). The side and size of adrenal tumours were demonstrated on computed tomography (n = 58) and/or magnetic resonance imaging (n = 20) scans. MIBG scans were performed in 38 patients. Four of these patients were found to have non-adrenal pathology (haemangioblastomas, haemangioma, a bronchogenic cyst and an angiomyolipoma); hence, the positive predictive value of MIBG scan was 90%. In a further five patients, MIBG raised the suspicion of local metastatic disease but this was not confirmed on operative findings and no recurrence was detected in these patients during 6-92-month follow-up. This led to an overall rate of false-positive rate of 23%. CONCLUSION: MIBG scintigraphy adds little to the routine preoperative management of patients with suspected PHAEO. Its use should be limited to the small minority of patients with negative cross-sectional imaging and those with recurrent or metastatic disease.
Authors:
Radu Mihai; Fergus Gleeson; Derek Roskell; Andrew Parker; Greg Sadler
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Publication Detail:
Type:  Journal Article     Date:  2008-07-29
Journal Detail:
Title:  Langenbeck's archives of surgery / Deutsche Gesellschaft für Chirurgie     Volume:  393     ISSN:  1435-2451     ISO Abbreviation:  Langenbecks Arch Surg     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-08     Completed Date:  2009-05-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9808285     Medline TA:  Langenbecks Arch Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  725-7     Citation Subset:  IM    
Affiliation:
Department of Endocrine Surgery, John Radcliffe Hospital, Oxford, UK. radumihai@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
3-Iodobenzylguanidine / diagnostic use
Adrenal Gland Neoplasms / radionuclide imaging*,  surgery*
Adult
Aged
Aged, 80 and over
False Positive Reactions
Female
Follow-Up Studies
Humans
Iodine Radioisotopes / diagnostic use
Male
Middle Aged
Pheochromocytoma / radionuclide imaging*,  surgery*
Preoperative Care*
Radionuclide Imaging*
Retrospective Studies
Unnecessary Procedures*
Young Adult
Chemical
Reg. No./Substance:
0/Iodine Radioisotopes; 77679-27-7/3-Iodobenzylguanidine

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