AccScience Publishing / ARNM / Volume 2 / Issue 1 / DOI: 10.36922/arnm.2506
Cite this article
11
Download
221
Views
Journal Browser
Volume | Year
Issue
Search
News and Announcements
View All
ORIGINAL RESEARCH ARTICLE

Blood glucose level affects iodine-123 labeled MIBG uptake in the lung

Andreas Lim1,2 Minseok Suh1 Gi Jeong Cheon1*
Show Less
1 Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Republic of Korea
2 Department of Nuclear Medicine and Molecular Theragnostic, Indriati General Hospital, Sukoharjo, Indonesia
Submitted: 21 December 2023 | Accepted: 8 January 2024 | Published: 27 March 2024
© 2024 by the Author (s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

The aim of this study was to evaluate the correlation of blood glucose and the metaiodobenzylguanidine (MIBG) uptake in lung and compare the difference between the lung uptake of MIBG in diabetic and non-diabetic patients. Patients who underwent iodine-123 MIBG whole-body scan (WBS) in the Department of Nuclear Medicine Seoul National University Hospital between January 2014 and July 2022 were recruited and analyzed. Semi-quantitative analysis of the mean value of lung-to-mediastinum ratio (LMR) was performed. Correlation was analyzed with Pearson correlation test and mean difference was analyzed with independent t-test. There were 36 patients in diabetic group and 57 patients in non-diabetic group with mean age of 56 ± 14.1 and 52 ± 14.6 years, respectively. The mean 24-h LMRs in diabetic and non-diabetic groups were 1.38 ± 0.20 and 1.17 ± 0.14, respectively. Fasting glucose showed a mean value of 136 ± 37.7 and 96 ± 8.2 mg/dL, respectively. There was a significant positive correlation in diabetic (r = 0.397; P = 0.016) and non-diabetic groups (r = 0.579; P <0.001) with significant mean difference (0.21; P <0.001). In conclusion, lung uptake of MIBG is positively correlated with blood sugar level, with diabetic patients displaying higher lung uptake of MIBG compared with non-diabetic patients. In addition, higher lung uptake of MIBG is evident in patients with higher fasting glucose level and even in non-diabetic patients. Thus, in the situations where MIBG therapy is required, the radiation dose to the lungs must be carefully adjusted for patients with high blood sugar level.

Keywords
Blood glucose level
Lung uptake
MIBG
Funding
This study is supported by the National Research Foundation of Korea (NRF-2020R1A2C2011428).
References
  1. Wieland DM, Wu J, Brown LE, Mangner TJ, Swanson DP, Beierwaltes WH. Radiolabeled adrenergic neuron-blocking agents: Adrenomedullary imaging with [131I] iodobenzylguanidine. J Nucl Med. 1980;21:349-353.

 

  1. Sisson JC, Wieland DM, Sherman P, Mangner TJ, Tobes MC, Jacques S Jr. Metaiodobenzylguanidine as an index of the adrenergic nervous system integrity and function. J Nucl Med. 1987;28:1620-1624.

 

  1. Kayano D, Kinuya S. Current consensus on I-131 MIBG therapy. Nucl Med Mol Imaging. 2018;52:254-265. doi: 10.1007/s13139-018-0523-z

 

  1. Dendy PP, Goldstone KE, Parkin A, Barber RW. Radiation protection. In: Sharp PF, Gemmell HG, Murray AD, editors. Practical Nuclear Medicine. London: Springer-Verlag; 2005. p. 91-111. doi: 10.1007/b136183

 

  1. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1-133. doi: 10.1089/thy.2015.0020

 

  1. Liu B, Zeng Y, Wang J, Zhao Z, Mu D, Kuang A. Lungs absorbed dose in radioiodine therapy of differentiated thyroid carcinoma with diffuse pulmonary metastases. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2010;27:851-854.

 

  1. Murata K, Sumida Y, Murashima S, et al. A novel method for the assessment of autonomic neuropathy in type 2 diabetic patients: A comparative evaluation of 123I-MIBG myocardial scintigraphy and power spectral analysis of heart rate variability. Diabet Med. 1996;13:266-272. doi: 10.1002/(SICI)1096-9136(199603)13:3<266:AID-DIA72>3.0.CO;2-4

 

  1. Mäntysaari M, Kuikka J, Mustonen J, et al. Noninvasive detection of cardiac sympathetic nervous dysfunction in diabetic patients using [123I] metaiodobenzylguanidine. Diabetes. 1992;41:1069-1075. doi: 10.2337/diab.41.9.1069

 

  1. Murashima S, Takeda K, Matsumura K, et al. Increased lung uptake of iodine-123-MIBG in diabetics with sympathetic nervous dysfunction. J Nucl Med. 1998;39:334-338.

 

  1. Unlü M, Inanir S. Prolonged lung retention of iodine-123- MIBG in diabetic patients. J Nucl Med. 1998;39:116-118.

 

  1. Mu X, Hasegawa S, Yoshioka J, et al. Clinical value of lung uptake of iodine-123 metaiodobenzylguanidine (MIBG), a myocardial sympathetic nerve imaging agent, in patients with chronic heart failure. Ann Nucl Med. 2001;15: 411-416.

 

  1. Hempel A, Maasch C, Heintze U, et al. High glucose concentrations increase endothelial cell permeability via activation of protein kinase CΑ. Circ Res. 1997;81:363-371. doi: 10.1161/01.res.81.3.363

 

  1. Canêo LF, Neirotti R. The importance of the proper definition of adulthood: What is and what is not included in a scientific publication. Braz J Cardiovasc Surg. 2017;32(1):60. doi: 10.21470/1678-9741-2016-0049

 

  1. Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg. 2018;126(5):1763-1768. doi: 10.1213/ANE.0000000000002864

 

  1. Neuroendocrine Tumours; 2017. Available from: https:// www.nhs.uk/conditions/neuroendocrine-tumours [Last accessed on 2023 Dec 20].

 

  1. Hong CM, Jeong YJ, Kim HW, et al. KSNM60 in Nuclear Endocrinology: from the Beginning to the Future. Nucl Med Mol Imaging. 2022;56(1):17-28. doi: 10.1007/s13139-021-00728-0

 

  1. Moll L, Mcewan A, Shapiro B, et al. Iodine-131 MIBG scintigraphy of neuroendocrine tumors other than pheochromocytoma and neuroblastoma. J Nucl Med. 1987;28(6):979-988.

 

  1. Binderup T, Knigge U, Loft A, et al. Functional imaging of neuroendocrine tumors: A head-to-head comparison of somatostatin receptor scintigraphy, 123I-MIBG scintigraphy, and 18F-FDG PET. J Nucl Med. 2010;51:704-712. doi: 10.2967/jnumed.109.069765

 

  1. Gould VE, Memoli V, Chejfec G, et al. The AUPD cell system and its neoplasms: Observations on the significance and limitations of the concept. Surg Clin N Am. 1979;59:93-107. doi: 10.1016/s0039-6109(16)41736-6

 

  1. Jaques S Jr., Tobes MC, Sisson JC, Baker JA, Wieland DM. Comparison of the sodium dependency of uptake of meta-lodobenzylguanidine and norepinephrine into cultured bovine adrenomedullary cells. Mol Pharmacol. 1984;26(3):539-546.

 

  1. Tobes MC, Jaques S, Wieland DM, Sisson JC. Effect of uptake-one inhibitors on the uptake of norepinephrine and metaiodobenzylguanidine. J Nucl Med. 1985;26(8):897-907.

 

  1. Mody VV, Singh AN, Deshmukh R, Shah S. Chapter 40 - Thyroid hormones, iodine and iodides, and antithyroid drugs. In: Ray SD, editor. A Worldwide Yearly Survey of New Data in Adverse Drug Reactions. Vol. 37. Netherlands: Elsevier; 2015. p. 513-519. Available from: https://www.sciencedirect.com/science/article/ pii/S0378608015000446?via%3Dihub [Last accessed on 2022 Nov 09].

 

  1. Mandel SJ, Shankar LK, Benard F, Yamamoto A, Alavi A. Superiority of iodine-123 compared with iodine-131 scanning for thyroid remnants in patients with differentiated thyroid cancer. Clin Nucl Med. 2001;26:6-9.

 

  1. Eleftheriadou A, Williams S, Nevitt S, et al. The prevalence of cardiac autonomic neuropathy in prediabetes: A systematic review. Diabetologia. 2021;64:288-303. doi: 10.1007/s00125-020-05316-z

 

  1. Zilliox LA, Russell JW. Is there cardiac autonomic neuropathy in prediabetes? Auton Neurosci. 2020;229:102722. doi: 10.1016/j.autneu.2020.102722

 

  1. Nathan DM, Davidson MB, DeFronzo RA, et al. Impaired fasting glucose and impaired glucose tolerance: Implications for care. Diabetes Care. 2007;30:753-759. doi: 10.2337/dc07-9920
Conflict of interest
The authors declare that they have no conflicts of interest.
Share
Back to top
Advances in Radiotherapy & Nuclear Medicine, Electronic ISSN: 2972-4392 Published by AccScience Publishing