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Treatment with 131I-mIBG (Metaiodobenzylguanidine): Indications, Procedures, and Results

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Clinical Applications of Nuclear Medicine Targeted Therapy

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Abstract

Since the 80s, treatment with 131I-metaiodobenzylguanidine (mIBG) has been introduced in the management of neuroendocrine tumors (NET). In several chromaffin tumors (neuroblastoma, pheochromocytoma, paraganglioma), but also medullary thyroid carcinoma and carcinoids, the efficacy and the possible role of 131I-mIBG treatment along disease course have been extensively investigated.

In children with high-risk refractory or recurrent neuroblastoma, the results of 131I-mIBG treatment have been improved by combinations with chemotherapy, radiosensitizers, and autologous stem cell support. Consequently, this treatment has been progressively incorporated into the more important multicenter trials.

For adult pheochromocytoma and paraganglioma, 131I-mIBG therapy is currently the most efficient nonsurgical therapeutic modality for inoperable or metastatic disease. In low-growing but symptomatic tumors, the powerful palliation of hormone-related secretory symptoms should also be considered when judging treatment benefit.

For other various NET types, with a wide range variability of mIBG-avid lesions, the role of this treatment is progressively decreasing by the emergence of peptide receptor radionuclide (PRRT).

Nevertheless in carcinoid tumors, 131I-MIBG remains a valid alternative radionuclide option for patients with renal impairment.

In this article, the most important practical aspects of 131I-MIBG therapy are listed and discussed.

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Acknowledgments

The authors are grateful to Emilio Bombardieri, MD, Scientific Director of Humanitas Gavazzeni Hospital, Bergamo (Italy), for his help and support in preparing this manuscript.

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Authors and Affiliations

  1. Nuclear Medicine Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy

    Maria Rita Castellani, Antonio Scarale, Alice Lorenzoni & Marco Maccauro

  2. Pediatric Oncology Unit, Hospital Universitario y Politecnico La Fe, Valencia, Spain

    Julia Balaguer Guill

  3. Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy

    Roberto Luksch

Authors
  1. Maria Rita Castellani
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  2. Antonio Scarale
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  3. Alice Lorenzoni
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  4. Marco Maccauro
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  5. Julia Balaguer Guill
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  6. Roberto Luksch
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Corresponding author

Correspondence to Maria Rita Castellani .

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Editors and Affiliations

  1. Department of Nuclear Medicine, Humanitas Gavazzeni Hospital, Bergamo, Italy

    Emilio Bombardieri

  2. Nuclear Medicine Therapy and Endocrinology, Istituto Nazionale dei Tumori, Milano, Italy

    Ettore Seregni

  3. Nuclear Medicine and Molecular Imaging Unit, Veneto Institute of Oncology IOV - IRCCS, Padova, Italy

    Laura Evangelista

  4. Nuclear Medicine Division, Istituto Nazionale dei Tumori, Milano, Italy

    Carlo Chiesa

  5. Nuclear Medicine, Humanitas Research Hospital, Rozzano, Milano, Italy

    Arturo Chiti

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Castellani, M.R., Scarale, A., Lorenzoni, A., Maccauro, M., Balaguer Guill, J., Luksch, R. (2018). Treatment with 131I-mIBG (Metaiodobenzylguanidine): Indications, Procedures, and Results. In: Bombardieri, E., Seregni, E., Evangelista, L., Chiesa, C., Chiti, A. (eds) Clinical Applications of Nuclear Medicine Targeted Therapy . Springer, Cham. https://doi.org/10.1007/978-3-319-63067-0_19

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