Page 15 - ARNM-2-1

Advances in Radiotherapy &

Nuclear Medicine

ORIGINAL RESEARCH ARTICLE
Blood glucose level affects iodine-123 labeled

MIBG uptake in the lung

Andreas Lim , Minseok Suh , and Gi Jeong Cheon *
1,2
1
1
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

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
*Corresponding author: positively correlated with blood sugar level, with diabetic patients displaying higher
Gi Jeong Cheon
(larrycheon@gmail.com) 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-
Citation: Lim A, Suh M, Cheon diabetic patients. Thus, in the situations where MIBG therapy is required, the radiation
GJ. Blood glucose level affects
iodine-123 labeled MIBG uptake dose to the lungs must be carefully adjusted for patients with high blood sugar level.
in the lung. Adv Radiother Nucl
Med. 2024;2(1):2506.
https://doi.org/10.36922/arnm.2506 Keywords: Blood glucose level; Lung uptake; MIBG
Received: December 21, 2023
Accepted: January 8, 2024
Published Online: March 27, 2024 1. Introduction
Copyright: © 2024 Author(s). Metaiodobenzylguanidine (MIBG) is an analog of the adrenergic neuron-blocking agent
This is an Open-Access article guanethidine, and it bears a high-degree resemblance in the aspects of uptake, storage,
distributed under the terms of the
Creative Commons Attribution release mechanisms, and structure with neurotransmitter norepinephrine (NE), which
License, permitting distribution, is predominantly released from the sympathetic nerve endings. MIBG can be labeled
1-3
and reproduction in any medium, with several radioiodine nuclides, such as I-131, and I-123, and has been used to image
provided the original work is
properly cited. and treat neuroendocrine tumours. 3
Publisher’s Note: AccScience I-131 emits two types of radiation: Beta minus (β-) used for therapy purposes, and
Publishing remains neutral with gamma (γ) for diagnostic purposes. In rare case, I-131 could cause pulmonary fibrosis
4
regard to jurisdictional claims in
published maps and institutional if there is diffuse uptake in the lung and the risk is increasing with higher cumulative
affiliations. amount given over an extended period. 5,6

Volume 2 Issue 1 (2024) 1 https://doi.org/10.36922/arnm.2506