(dtpa-phe(1))-octreotide and Neuroblastoma

Nuclear imaging techniques such as bone scans, metaiodobenzylguanidine (MIBG) scans, and (111)In-diethylenetriaminepentaacetic acid-octreotide scans have greatly increased the sensitivity and specificity of both diagnostic and follow-up protocols for pediatric solid tumors. Molecular targets that are specific for certain pediatric tumors are now being developed. Targets include cell membrane receptors targeted by specific ligands, subcellular organelles targeted by false transmitters, and cellular proteins targeted by antibodies. This review focuses on the use of MIBG (which is a false transmitter) and octreotide (which is a ligand for G protein receptor) in the diagnosis and treatment of solid tumors that affect children and young adults.

Topics: 3-Iodobenzylguanidine; Animals; Child; Child, Preschool; Clinical Trials as Topic; Humans; Infant; Infant, Newborn; Neuroblastoma; Octreotide; Patient Selection; Pentetic Acid; Practice Guidelines as Topic; Practice Patterns, Physicians'; Radiation Injuries; Radionuclide Imaging; Radiopharmaceuticals; Somatostatin; Treatment Outcome

A case of a 30 year old male with an eight year history of neuroblastoma and whose general health was good is presented. After his last check-up, which included a CT scan and 99mTc-MDP bone scintigraphy, a 123I-MIBG and 111In-DTPA-D-Pheoctreotide scintigraphy was performed and provided us with complementary data that contributed to a more precise diagnosis of the location and extension of the neuroblastoma and to the biological features of the tumor. Thus, this report deals with an adult neuroblastoma patient whose general health is good in whom the exact extension of the lesion was determined by a combination of diagnostic imaging techniques.

Topics: 3-Iodobenzylguanidine; Adrenal Gland Neoplasms; Adult; Biomarkers, Tumor; Bone Marrow; Bone Neoplasms; Humans; Iodine Radioisotopes; Lymphatic Metastasis; Male; Neoplasm Proteins; Neoplasm Recurrence, Local; Neuroblastoma; Octreotide; Pentetic Acid; Prognosis; Radionuclide Imaging; Receptors, Somatostatin

An account is given of the results observed with I-131 MIBG scintigraphy in four patients (1 bladder pheochromocytoma, 3 neuroblastomas) chosen on account of their particular clinical and diagnostic interest from a series of 41 apudoma patients examined by means of this technique. In the first patient, the unusual site of the tumor in the posterior wall of the bladder meant that its detection by I-131 MIBG was only possible after catheterization of the bladder. In the second patient, uptake in the metastasis was only evident after removal of the primary tumor. In the third patient, the scintiscan revealed several metastases (some in bone) not detected by CT. In the fourth patient (congenital neuroblastoma), enhanced uptake accompanied the appearance of high plasma catecholamine and urinary vanillylhandelic acid values, suggesting a functional switch from a nonsecreting to a secreting form. a supplementary In-111 DTPA-Octreotide (OCT) scintiscan of this patient demonstrated the presence of somatostatin receptors on the neuroblasts. Thus, this examination would seem particularly useful for the differentiation of nonsecreting neuroblastomas. Its employment in assessment of the therapeutic capacity of OCT itself is also suggested.

Topics: 3-Iodobenzylguanidine; Adolescent; Adrenal Gland Neoplasms; Child, Preschool; Humans; Indium Radioisotopes; Infant; Iodine Radioisotopes; Iodobenzenes; Neuroblastoma; Octreotide; Pentetic Acid; Pheochromocytoma; Radionuclide Imaging; Thoracic Neoplasms; Urinary Bladder Neoplasms

The aim of this study was to use compartmental analysis as a theoretical tool to provide quantitative and unitary data for a more precise determination of 111In-OCT concentrations in a tumour site and various body organs. Five subjects (3 male and 2 female) with neoplasias were studied. Structural and parametric identification of the model was based on the plasma, urine, total body and ROI (soft tissue, spleen, kidney and tumour) activity values. The model was of the mammillary type with 5 compartments (blood, soft tissue, spleen, kidneys and urine) for the 4 patients with a negative scintiscan and 6 (blood, soft tissue, spleen, kidneys, urine and tumour) for the adenocarcinoma patient. Numerical constants were determined by running a best-fit procedure with the MINUIT minimisation program (CERN library) using a microVAX 3800 computer. The reliability of the models was also tested. 111In-OCT accumulates in the kidneys and spleen, from which it is slowly released into the blood. Elimination is via the urine at first rapidly, then more slowly. The maximum concentration in the tumour compartment is reached at 12-14 hours and remains almost constant.

Topics: Adenocarcinoma; Carcinoma, Small Cell; Computer Simulation; Female; Humans; Indium Radioisotopes; Kidney; Lung Neoplasms; Male; Metabolic Clearance Rate; Models, Biological; Models, Chemical; Neuroblastoma; Neuroectodermal Tumors; Octreotide; Pentetic Acid; Radiopharmaceuticals; Reproducibility of Results; Spleen; Tissue Distribution

Topics: 3-Iodobenzylguanidine; Antineoplastic Agents; Child, Preschool; DNA, Neoplasm; Female; Humans; Indium Radioisotopes; Infant; Iodine Radioisotopes; Iodobenzenes; Male; Neuroblastoma; Octreotide; Pentetic Acid; Ploidies; Prospective Studies; Radionuclide Imaging; Receptors, Somatostatin

Topics: 3-Iodobenzylguanidine; Chromosome Deletion; Chromosomes, Human, Pair 1; Female; Follow-Up Studies; Humans; Indium Radioisotopes; Infant; Iodine Radioisotopes; Iodobenzenes; Male; Neoplasm Recurrence, Local; Neuroblastoma; Octreotide; Pentetic Acid; Ploidies; Prognosis; Radionuclide Imaging; Receptors, Somatostatin; Survival Rate