We reviewed nuclear endocrinological examinations of the thyroid, parathyroid, and adrenal glands that are clinically performed in Japan as well as somatostatin receptor imaging, which is widely used in Europe, the United States, and other countries. 123I thyroid scintigraphy is especially useful in detecting ectopic goiters and differentiating between Basedow's disease and subacute thyroiditis or Plummer's disease, all of which exhibit thyrotoxicosis. 201Tl is useful to detect foci metastasized from well differentiated thyroid cancer and to differentiate malignant from benign tumors. 67Ga-citrate is an agent used for patients suspected of having malignant lymphoma or undifferentiated carcinoma of the thyroid. Radioiodinated MIBG is a specific agent for medullary thyroid carcinoma. 99mTc-MIBI is a good agent for locating hyperfunctioning parathyroid tissues. 131I-adosterol is useful to locate the lesions of primary aldosteronism, Cushing's syndrome, adrenogenital syndrome, and select adenomas among incidental tumors. Radioiodinated MIBG scintigraphy has high diagnostic accuracy in locating pheochromocytomas and neuroblastomas. 111In-labeled octreotide is useful in locating, hormone-producing gastrointestinal and pancreatic tumors including carcinoids, gastrinomas, and insulinomas. Radiolabeled somatostatin receptor analogs are used not only to locate but also to treat malignant somatostatin receptor-positive tumors. We hope that Octreoscan will be available in Japan in the near future.

01 Jan 1997·The Japanese Journal of Urology

CLINICAL EVALUATION OF SCINTIGRAPHY AND TUMOR BIOPSY FOR INCIDENTALY DETECTED ADRENAL MASSES

Article

Author: Watanabe, H ; Inui, E ; Kojima, M ; Ochiai, A ; Ukimura, O

PURPOSEA decision tree in diagnosis of incidentally detected adrenal masses (incidentaloma) was made on the basis of these results.METHODSThe clinical usefulness of adrenal scintigraphy with 131I-adosterol and ultrasonically guided tumor biopsy was investigated in 44 patients.RESULTSAdrenal scintigraphy was performed in 32 patients, of whom 21 were found to have an increased uptake in the tumor, including 19 cases of cortical adenoma and 2 of hematoma. No abnormal uptake was found in the remaining 11 patients, including 2 of cortical adenoma, 1 of adrenocortical oncocytoma and 8 of non-cortical tumors. Adrenal scintigraphy was thus thought to be useful in the differentiation of cortical tumor from non-cortical tumor, showing the sensitivity of 86%, the specificity of 80% and the diagnostic accuracy of 84%. Cytological or histological study on specimens obtained by percutaneous adrenal tumor biopsy was performed in 19 patients, of whom 18 (95%) were correctly diagnosed in terms of the malignancy of incidentaloma.CONCLUSIONSTaken together, the differential diagnosis and the surgical indication of adrenal incidentaloma could be made successfully based on adrenal scintigraphy and tumor biopsy.

01 Jan 1985·Folia Endocrinologica Japonica

Image Diagnosis of Adrenal Disorders-III.

Article

Author: MINAMORI, Yoshiaki ; KIKUCHI, Masakuni ; MURASE, Hiroshi ; MURAYAMA, Masanori ; MIURA, Kiyoshi ; GOSHIMA, Eiichi ; YAMAKITA, Noriyoshi ; YASUDA, Keiao ; IMAEDA, Takeyoshi ; MATSUNAMI, Eiichi ; SUGIYAMA, Kohji

The image diagnoses of a case of so-called "nonfunctioning" adrenal adenoma, weak mineralocorticoids producing adrenal carcinoma, congenital adrenogenital syndrome due to 21-hydroxylase deficiency--simple virilizing form--, and 5 cases of pheochromocytoma were studied. In a patient with so-called "nonfunctioning" adrenal adenoma (2.3 X 3.0 X 3.3 cm), in which steroids biosynthesis was confirmed, computed tomography (CT) delineated the tumor shadow with extremely low density, and ultrasonography (US) demonstrated the round tumor echo with homogenous and low echogenicity at the superior region of the right renal pole. Adrenal scintigraphy also showed the tumor image. A weak mineralocorticoids-producing left adrenal carcinoma (3.5 X 3.5 X 3.0 cm) was shown as a heterogenous round tumor at the left lateral portion of the vertebra by CT. On adrenal scintigraphy under dexamethasone pretreatment, there was good uptake in the tumor and disappearance of the contralateral. Both bilateral adrenal images on CT in a patient with congenital adrenogenital syndrome were linear-shaped and markedly enlarged. The enlarged right adrenal was clearly demonstrated by US with an electronic sector scanner but not with an electronic linear scanner, although the left one was hardly shown by either US instruments. Three of 4 patients with pheochromocytomas examined by US were correctly detected, while in the remaining one the tumor image was judged to be a retroperitoneal tumor. CT also correctly demonstrated the former 3 pheochromocytomas, but misjudged the latter one as a pancreatic cancer. Good uptake of Adosterol by bilateral adrenals was shown in a case of extra-adrenal pheochromocytoma. Three of 4 cases of adrenal pheochromocytoma showed the isotope uptake of the contralateral normal adrenal alone. In another case of right adrenal pheochromocytoma, isotope accumulation in the colon obscured whether the isotope uptake in the right adrenal was shown or not.

100 Deals associated with Iodinated (131I) Methylnorcholestenol

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Indication	Country/Location	Organization	Date
Diagnostic agents	JP	PDRadiopharma, Inc.	10 Jun 1980

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