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Re: Adrenal Scintigraphy

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We abandoned this also about 30 years ago. Maybe new ones are better but as we are picking up smaller bumps my guess it still is not as good as AVS with ACTH Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertensionOn Dec 30, 2009, at 3:17 PM, MaxJasper <maxjasper@...> wrote:

It appears that this method can replace AVS, is that true:

Adrenal Scintigraphy. The widespread application of adrenal scintigraphy is limited by the lack of experienced nuclear medicine centers. In addition to anatomical localization, adrenocortical scintigraphy provides a functional characterization of the adrenals based on the uptake and accumulation in functioning adrenocortical tissues of radiotracers, such as iodocholesterol-labeled analogs (131 I-6--iodomethyl-19-norcholesterol [NP-59] and 75 Se-6--selenomethyl cholesterol). Hypersecreting tumors (eg, cortisol, aldosterone, and androgen secreting adenomas) and nonhypersecreting adenomas show radiocholesterol uptake, whereas primary and secondary adrenal malignancies appear as "cold" nodules. Incidentalomas may show different radiocholesterol uptake patterns related to their nature and functional status.

Adrenal medullary scintigraphy requires radioiodinated guanethidine analogs, 131I-MIBG and 123I-MIGB, which are specifically concentrated in the sympathomedullary system by the active high-affinity type 1 transport mechanism. 123I-MIGB scintigraphy localizes pheochromocytoma as focal increased adrenal uptake with 86% sensitivity and 99% specificity. Masses less than 1.5 to 2 cm in diameter and large tumors with extensive tumoral necrosis and/or hemorrhage may not show sufficient MIBG uptake for visualization. False-negative results also may be due to drugs that interfere with uptake. [Ref.]

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I'm not sure what this method is. Is it invasive? If so, its simply a new form of AVS.

Why are you so resistant to getting an AVS. If the AVS scares you, how are you going to face an adrenalectomy - which makes an AVS seem like child's play.

Just get a scrip for Spiro and be done with it (and DASH unless you are carb addicted - then you will need a low salt but high protein diet with lots of potassium at the reward meal).

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From: MaxJasper <maxjasper@...>Subject: Adrenal Scintigraphyhyperaldosteronism Date: Wednesday, December 30, 2009, 6:17 PM

It appears that this method can replace AVS, is that true:

Adrenal Scintigraphy. The widespread application of adrenal scintigraphy is limited by the lack of experienced nuclear medicine centers. In addition to anatomical localization, adrenocortical scintigraphy provides a functional characterization of the adrenals based on the uptake and accumulation in functioning adrenocortical tissues of radiotracers, such as iodocholesterol- labeled analogs (131 I-6--iodomethyl- 19-norcholestero l [NP-59] and 75 Se-6--selenomethyl cholesterol) . Hypersecreting tumors (eg, cortisol, aldosterone, and androgen secreting adenomas) and nonhypersecreting adenomas show radiocholesterol uptake, whereas primary and secondary adrenal malignancies appear as "cold" nodules.

Incidentalomas may show different radiocholesterol uptake patterns related to their nature and functional status.

Adrenal medullary scintigraphy requires radioiodinated guanethidine analogs, 131I-MIBG and 123I-MIGB, which are specifically concentrated in the sympathomedullary system by the active high-affinity type 1 transport mechanism. 123I-MIGB scintigraphy localizes pheochromocytoma as focal increased adrenal uptake with 86% sensitivity and 99% specificity. Masses less than 1..5 to 2 cm in diameter and large tumors with extensive tumoral necrosis and/or hemorrhage may not show sufficient MIBG uptake for visualization. False-negative results also may be due to drugs that interfere with uptake. [Ref.]

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" Masses less than 1.5 to 2 cm in diameter and large tumors with extensive

tumoral necrosis and/or hemorrhage may not show sufficient MIBG uptake for

visualization. "

Adenomas that cause great

distress from over-production of aldosterone can be the size of a grain of

sand.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of MaxJasper

It appears that this method can

replace AVS, is that true:

Adrenal

Scintigraphy. The widespread application of adrenal scintigraphy is limited by

the lack of experienced nuclear medicine centers. In addition to anatomical

localization, adrenocortical scintigraphy provides a functional

characterization of the adrenals based on the uptake and accumulation in

functioning adrenocortical tissues of radiotracers, such as iodocholesterol-labeled

analogs (131 I-6--iodomethyl-19-norcholesterol [NP-59] and 75

Se-6--selenomethyl cholesterol). Hypersecreting tumors (eg, cortisol,

aldosterone, and androgen secreting adenomas) and nonhypersecreting adenomas

show radiocholesterol uptake, whereas primary and secondary adrenal

malignancies appear as " cold " nodules. Incidentalomas may show

different radiocholesterol uptake patterns related to their nature and

functional status.

Adrenal

medullary scintigraphy requires radioiodinated guanethidine analogs, 131I-MIBG

and 123I-MIGB, which are specifically concentrated in the

sympathomedullary system by the active high-affinity type 1 transport

mechanism. 123I-MIGB scintigraphy localizes pheochromocytoma as

focal increased adrenal uptake with 86% sensitivity and 99% specificity. Masses

less than 1.5 to 2 cm in diameter and large tumors with extensive tumoral

necrosis and/or hemorrhage may not show sufficient MIBG uptake for

visualization. False-negative results also may be due to drugs that interfere

with uptake. [Ref.]

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Do you think it applies to Scintigraphy too?

"Masses less than 1.5 to 2 cm in diameter and large tumors with extensive tumoral necrosis and/or hemorrhage may not show sufficient MIBG uptake for visualization."

Adenomas that cause great distress from over-production of aldosterone can be the size of a grain of sand.

Val

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That quote was taken from your article on scintigraphy.

Val

>

> Do you think it applies to Scintigraphy too?

> " Masses less than 1.5 to 2 cm in diameter and large tumors with extensive

tumoral necrosis and/or hemorrhage may not show sufficient MIBG uptake for

visualization. "

>

> Adenomas that cause great distress from over-production of aldosterone can be

the size of a grain of sand.

>

> Val

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MIBG is scintigraphyOn Dec 30, 2009, at 9:33 PM, MaxJasper wrote:Do you think it applies to Scintigraphy too?"Masses less than 1.5 to 2 cm in diameter and large tumors with extensive tumoral necrosis and/or hemorrhage may not show sufficient MIBG uptake for visualization." Adenomas that cause great distress from over-production of aldosterone can be the size of a grain of sand. Val

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