succimer and Pheochromocytoma

Dimercaptosuccinic acid (DMSA) exists in meso and racemic (rac) forms. Unlike a meso isomer, rac-2,3-DMSA is very soluble in water, strongly acidic solutions and organic solvents. Despite these differences, rac-2,3-DMSA has not been studied as a radiopharmaceutical. In this study, (188)Re complexes with diastereomeric DMSA were prepared to compare the properties of 188Re(V)-rac-DMSA with those of 188Re(V)-meso-DMSA in in vitro and in vivo models.. rac-2,3-DMSA was synthesized and radiolabeled with 188Re. The biodistribution and gamma camera imaging of 188Re(V)-meso-DMSA and 188Re(V)-rac-DMSA were performed in nude mice subcutaneously implanted with PC-12 cell lines.. Both 188Re(V)-meso-DMSA and 188Re(V)-rac-DMSA showed excellent radiochemical purity and stability at room temperature. Compared with 188Re(V)-meso-DMSA, 188Re(V)-rac-DMSA needed a higher concentration of rac-DMSA and metabisulfite for maximum yields. 188Re(V)-meso-DMSA showed high labeling efficiency at pH 2, whereas 188Re(V)-rac-DMSA showed maximum yields at pH 5. The tumor uptake of 188Re(V)-rac-DMSA was 3.5 times higher than that of 188Re(V)-meso-DMSA at 1 h (P<.01). Gamma camera images showed that 188Re(V)-rac-DMSA was more selectively localized than 188Re(V)-meso-DMSA at the tumor region in a xenograft model. These results demonstrate that 188Re(V)-rac-DMSA may have better potential than 188Re(V)-meso-DMSA as a therapeutic agent against neuroendocrine tumors.

Topics: Animals; Cell Line; Female; Isotope Labeling; Metabolic Clearance Rate; Mice; Mice, Inbred C57BL; Mice, Nude; Organ Specificity; Organometallic Compounds; Pheochromocytoma; Radionuclide Imaging; Radiopharmaceuticals; Rats; Succimer; Tissue Distribution

We report a girl with extra-adrenal pheochromocytoma complicated with impaired renal function of the ipsilateral kidney, discussing aetiologies. A 14-year-old girl presented with uncontrolled hypertension, high urinary vanillylmandelic acid level and a 5 x 6 cm mass at the right renal hilum. Her blood pressure was under control with propranolol, prazosin, and nifedipine before surgery, and with sodium nitroprusside during surgical intervention. The total tumour removal required reconstruction of the right renal vein. Histopathology confirmed pheochromocytoma. Dimercaptosuccinic acid (DMSA) after surgery showed low uptake of isotope by the right kidney; it was unclear if this was due to the surgery or the tumour causing renal artery stenosis, but fortunately her blood pressure returned to normal thereafter. We recommend obtaining a DMSA in the preoperative evaluation of pheochromocytoma.

Topics: Adolescent; Adrenal Gland Neoplasms; Blood Pressure; Female; Humans; Hypertension; Image Enhancement; Kidney; Kidney Diseases; Kidney Function Tests; Pheochromocytoma; Postoperative Period; Radionuclide Imaging; Succimer; Tomography, X-Ray Computed

Topics: Adrenal Gland Neoplasms; Chelating Agents; Child, Preschool; Diagnosis, Differential; Humans; Hypertension; Male; Mercury Poisoning; Pheochromocytoma; Succimer; Sweating

Topics: 3-Iodobenzylguanidine; Adrenal Gland Neoplasms; Diagnosis, Differential; False Positive Reactions; Female; Humans; Hydronephrosis; Iodine Radioisotopes; Iodobenzenes; Middle Aged; Organotechnetium Compounds; Pheochromocytoma; Radionuclide Imaging; Radiopharmaceuticals; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Medronate; Technetium Tc 99m Pentetate; Tomography, X-Ray Computed; Urography

Topics: Adrenal Gland Neoplasms; Adult; Breast Neoplasms; Carcinoma, Medullary; False Positive Reactions; Female; Fibrocystic Breast Disease; Humans; Multiple Endocrine Neoplasia; Organotechnetium Compounds; Pheochromocytoma; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Thyroid Neoplasms

This case report describes 99mTc(V)-dimercaptosuccinic acid (DMSA) accumulation in a pheochromocytoma in a patient with Sipple's syndrome. Scintigraphy with 99mTc(V)-DMSA demonstrated uptake in medullary carcinoma of the thyroid gland (MCT). Iodine-131 metaiodobenzylguanidine (MIBG) scintigraphy showed the bilateral pheochromocytomas but did not demonstrate uptake in the MCT.

Topics: 3-Iodobenzylguanidine; Adrenal Gland Neoplasms; Carcinoma; Humans; Iodine Radioisotopes; Iodobenzenes; Male; Middle Aged; Multiple Endocrine Neoplasia; Organotechnetium Compounds; Pheochromocytoma; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium Tc 99m Dimercaptosuccinic Acid; Thyroid Neoplasms

Recently developed radiopharmaceuticals have been proposed for imaging medullary thyroid carcinoma (MTC) with some having therapeutic potential. This study compares the imaging results obtained with radioiodinated meta-iodo-benzylguanidine (MIBG), 99mTc (V) DMSA, and 131I F(ab')2 anti-carcinoembryonic antigen (anti-CEA) in a group of MTC patients. In 23 patients 131I MIBG imaging showed a high specificity (no false-positive results) but a less satisfactory sensitivity (50%). In 12 patients 99mTc (V) DMSA revealed a better sensitivity (77%) but a lower specificity (three false-positive results). Positive results were obtained in two of three patients studied with 131I F(ab')2 anti-CEA. These data suggest that the highly sensitive 99mTc (V) DMSA should be considered as a first choice procedure followed by the highly specific radioiodinated MIBG to confirm the initial results. Since radioiodinated MIBG imaging may have therapeutic usefulness, 131I MIBG was evaluated in an integrated treatment protocol in four cases of proven MTC. The preliminary results obtained were encouraging.

Topics: 3-Iodobenzylguanidine; Adolescent; Adrenal Gland Neoplasms; Adult; Aged; Carcinoembryonic Antigen; Carcinoma; Female; Humans; Iodine Radioisotopes; Iodobenzenes; Male; Middle Aged; Multiple Endocrine Neoplasia; Organotechnetium Compounds; Pheochromocytoma; Prognosis; Recurrence; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Thyroid Neoplasms; Tomography, Emission-Computed

A case of false positive I-131 MIBG imaging for detection of pheochromocytoma is presented. There was an area of increased tracer uptake in the left renal region that showed steadily reducing activity over a period of three days. This raised the suspicion of a dilated renal pelvis, which was later confirmed by Tc-99m DTPA imaging. It is advisable in cases of ambiguous I-131 MIBG imaging to use Tc-99m DTPA rather than Tc-99m DMSA for localizing the kidneys and renal pelvis.

Topics: 3-Iodobenzylguanidine; Adult; Diagnosis, Differential; False Positive Reactions; Humans; Iodine Radioisotopes; Iodobenzenes; Kidney Diseases; Kidney Pelvis; Male; Organometallic Compounds; Pentetic Acid; Pheochromocytoma; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate

This case report describes the localization and categorization of tumors using 99mTc(V)-dimercaptosuccinic acid and [131I]metaiodobenzylguanidine scans in a very uncommon case of medullary thyroid carcinoma associated with pheochromocytoma (Sipple's syndrome) and hepatocellular carcinoma. Technetium-99m(V)-dimercaptosuccinic acid showed accumulation only in medullary thyroid carcinoma, but [131I]metaiodobenzylguanidine scans were positive in both medullary thyroid carcinoma and pheochromocytoma. In advanced Sipple's syndrome, combined use of [99mTc(V)]dimercaptosuccinic acid and [131I]metaiodobenzylguanidine may be useful for the categorization of tumor mass lesions and planning appropriate therapy.

Topics: 3-Iodobenzylguanidine; Adrenal Gland Neoplasms; Aged; Carcinoma; Carcinoma, Hepatocellular; Humans; Iodine Radioisotopes; Iodobenzenes; Liver Neoplasms; Male; Multiple Endocrine Neoplasia; Neoplasms, Multiple Primary; Organometallic Compounds; Pheochromocytoma; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Thyroid Neoplasms

The exact localization of adrenal lesions can be achieved by noninvasive procedures. Whereas radiological methods reflect morphological changes, scintigraphy of adrenal cortex and medulla depends on function. - Radiolabeled 6 beta-methyl-19-norcholesterol is used for adrenocortical scintigraphy in primary aldosteronism, Cushing's syndrome and hyperandrogenism. By dexamethasone suppression a correct classification of adrenocortical lesions by scintigraphy can be observed in about 89% with a specificity of 86%. 123-I- and 131-I-metaiodobenzylguanidine is used for specific scintigraphy of the adrenal medulla. This method is a safe and reliable method for localization of adrenal and extraadrenal pheochromocytomas.

Topics: 19-Iodocholesterol; 3-Iodobenzylguanidine; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Cholesterol; Cushing Syndrome; Dexamethasone; Humans; Hyperaldosteronism; Iodobenzenes; Pheochromocytoma; Radionuclide Imaging; Selenium; Succimer; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid