Urinary Dopamine Levels Can Predict the Avidity of Post-Therapy [<sup>131</sup>I]MIBG Scintigraphy in Unresectable or Metastatic Pheochromocytomas and Paragangliomas: A Preliminary Clinical Study

<b>Background/Objectives</b>: Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors that produce catecholamines. Unresectable or metastatic PPGLs are treated with [<sup>131</sup>I]metaiodobenzylguanidine (MIBG), but MIBG avidity is often heterogeneous. I...

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Main Authors: Junki Takenaka, Shiro Watanabe, Takashige Abe, Satoshi Takeuchi, Kenji Hirata, Rina Kimura, Hiroshi Ishii, Naoto Wakabayashi, Mungunkhuyag Majigsuren, Kohsuke Kudo
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Language:English
Published: MDPI AG 2025-01-01
Series:Pharmaceuticals
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Online Access:https://www.mdpi.com/1424-8247/18/2/165
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author Junki Takenaka
Shiro Watanabe
Takashige Abe
Satoshi Takeuchi
Kenji Hirata
Rina Kimura
Hiroshi Ishii
Naoto Wakabayashi
Mungunkhuyag Majigsuren
Kohsuke Kudo
author_facet Junki Takenaka
Shiro Watanabe
Takashige Abe
Satoshi Takeuchi
Kenji Hirata
Rina Kimura
Hiroshi Ishii
Naoto Wakabayashi
Mungunkhuyag Majigsuren
Kohsuke Kudo
author_sort Junki Takenaka
collection DOAJ
description <b>Background/Objectives</b>: Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors that produce catecholamines. Unresectable or metastatic PPGLs are treated with [<sup>131</sup>I]metaiodobenzylguanidine (MIBG), but MIBG avidity is often heterogeneous. Identifying predictive factors for non-avid lesions on scintigraphy is clinically important. The primary objective of this study was to investigate the relationship between MIBG avidity and catecholamine secretion patterns in patients with unresectable or metastatic PPGLs. <b>Methods</b>: This retrospective study included 27 patients treated with [<sup>131</sup>I]MIBG for unresectable/metastatic PPGLs between 2001 and 2024. Patients received a single intravenous dose of [<sup>131</sup>I]MIBG (5.5–7.4 GBq), with post-therapy scintigraphy performed 3–7 days later. Non-avid lesions were assessed by imaging and confirmed using CT, MRI, and FDG-PET. Clinical factors, including age, sex, prior treatments, metastasis sites, and urine catecholamines, were evaluated using univariate logistic analysis. Predictive factors were assessed via receiver operating characteristic curves. <b>Results</b>: Non-avid lesions were found in nine patients (33.3%). These patients were younger (median age 38 vs. 62.5 years) and had higher urine dopamine levels (median 1510 vs. 779 μg/day) than those without non-avid lesions. Younger age (odds ratio: 0.892, <i>p</i> < 0.01) and higher urinary dopamine levels (odds ratio: 1.003, <i>p</i> < 0.01) were significantly associated with non-avid lesions. All patients > 45 years with urinary dopamine < 1190 μg/day had no non-avid lesions, whereas patients < 45 years with urinary dopamine > 1190 μg/day had non-avid lesions. <b>Conclusions</b>: Age and urinary dopamine levels may predict non-avid lesions in unresectable/metastatic PPGLs, aiding treatment decisions for [<sup>131</sup>I]MIBG therapy. This article is a revised and expanded version of a paper entitled “Urine dopamine level and age can predict non-avid lesion on scintigraphy after I-131 MIBG treatment for unresectable/metastatic PPGL”, which was presented at SNMMI 2024, Toronto, from 8 June to 11 June 2024.
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spelling doaj-art-dac0ad1b91b141d4ad0c606086d8025d2025-08-20T03:11:22ZengMDPI AGPharmaceuticals1424-82472025-01-0118216510.3390/ph18020165Urinary Dopamine Levels Can Predict the Avidity of Post-Therapy [<sup>131</sup>I]MIBG Scintigraphy in Unresectable or Metastatic Pheochromocytomas and Paragangliomas: A Preliminary Clinical StudyJunki Takenaka0Shiro Watanabe1Takashige Abe2Satoshi Takeuchi3Kenji Hirata4Rina Kimura5Hiroshi Ishii6Naoto Wakabayashi7Mungunkhuyag Majigsuren8Kohsuke Kudo9Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, JapanDepartment of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, JapanDepartment of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, JapanDepartment of Medical Oncology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, JapanDepartment of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, JapanDepartment of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, JapanDepartment of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, JapanDepartment of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, JapanDepartment of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, JapanDepartment of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan<b>Background/Objectives</b>: Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors that produce catecholamines. Unresectable or metastatic PPGLs are treated with [<sup>131</sup>I]metaiodobenzylguanidine (MIBG), but MIBG avidity is often heterogeneous. Identifying predictive factors for non-avid lesions on scintigraphy is clinically important. The primary objective of this study was to investigate the relationship between MIBG avidity and catecholamine secretion patterns in patients with unresectable or metastatic PPGLs. <b>Methods</b>: This retrospective study included 27 patients treated with [<sup>131</sup>I]MIBG for unresectable/metastatic PPGLs between 2001 and 2024. Patients received a single intravenous dose of [<sup>131</sup>I]MIBG (5.5–7.4 GBq), with post-therapy scintigraphy performed 3–7 days later. Non-avid lesions were assessed by imaging and confirmed using CT, MRI, and FDG-PET. Clinical factors, including age, sex, prior treatments, metastasis sites, and urine catecholamines, were evaluated using univariate logistic analysis. Predictive factors were assessed via receiver operating characteristic curves. <b>Results</b>: Non-avid lesions were found in nine patients (33.3%). These patients were younger (median age 38 vs. 62.5 years) and had higher urine dopamine levels (median 1510 vs. 779 μg/day) than those without non-avid lesions. Younger age (odds ratio: 0.892, <i>p</i> < 0.01) and higher urinary dopamine levels (odds ratio: 1.003, <i>p</i> < 0.01) were significantly associated with non-avid lesions. All patients > 45 years with urinary dopamine < 1190 μg/day had no non-avid lesions, whereas patients < 45 years with urinary dopamine > 1190 μg/day had non-avid lesions. <b>Conclusions</b>: Age and urinary dopamine levels may predict non-avid lesions in unresectable/metastatic PPGLs, aiding treatment decisions for [<sup>131</sup>I]MIBG therapy. This article is a revised and expanded version of a paper entitled “Urine dopamine level and age can predict non-avid lesion on scintigraphy after I-131 MIBG treatment for unresectable/metastatic PPGL”, which was presented at SNMMI 2024, Toronto, from 8 June to 11 June 2024.https://www.mdpi.com/1424-8247/18/2/165PPGL[<sup>131</sup>I]MIBG therapyurine catecholamine
spellingShingle Junki Takenaka
Shiro Watanabe
Takashige Abe
Satoshi Takeuchi
Kenji Hirata
Rina Kimura
Hiroshi Ishii
Naoto Wakabayashi
Mungunkhuyag Majigsuren
Kohsuke Kudo
Urinary Dopamine Levels Can Predict the Avidity of Post-Therapy [<sup>131</sup>I]MIBG Scintigraphy in Unresectable or Metastatic Pheochromocytomas and Paragangliomas: A Preliminary Clinical Study
Pharmaceuticals
PPGL
[<sup>131</sup>I]MIBG therapy
urine catecholamine
title Urinary Dopamine Levels Can Predict the Avidity of Post-Therapy [<sup>131</sup>I]MIBG Scintigraphy in Unresectable or Metastatic Pheochromocytomas and Paragangliomas: A Preliminary Clinical Study
title_full Urinary Dopamine Levels Can Predict the Avidity of Post-Therapy [<sup>131</sup>I]MIBG Scintigraphy in Unresectable or Metastatic Pheochromocytomas and Paragangliomas: A Preliminary Clinical Study
title_fullStr Urinary Dopamine Levels Can Predict the Avidity of Post-Therapy [<sup>131</sup>I]MIBG Scintigraphy in Unresectable or Metastatic Pheochromocytomas and Paragangliomas: A Preliminary Clinical Study
title_full_unstemmed Urinary Dopamine Levels Can Predict the Avidity of Post-Therapy [<sup>131</sup>I]MIBG Scintigraphy in Unresectable or Metastatic Pheochromocytomas and Paragangliomas: A Preliminary Clinical Study
title_short Urinary Dopamine Levels Can Predict the Avidity of Post-Therapy [<sup>131</sup>I]MIBG Scintigraphy in Unresectable or Metastatic Pheochromocytomas and Paragangliomas: A Preliminary Clinical Study
title_sort urinary dopamine levels can predict the avidity of post therapy sup 131 sup i mibg scintigraphy in unresectable or metastatic pheochromocytomas and paragangliomas a preliminary clinical study
topic PPGL
[<sup>131</sup>I]MIBG therapy
urine catecholamine
url https://www.mdpi.com/1424-8247/18/2/165
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