Fig. 25.21 Therapy of malignant paraganglioma with 131I MlBG The anterior view (a) of the thorax shows multiple sites of abnormal uptake in the upper mediastinum before therapy. During a course of therapy (b): after a total of two doses of 8.9GBq (240mCi) of 131I MIBG, six months later (T: mediastinal tumour arrow; lung metastasis: Ad; adrenal medulla). Image (c) taken after a total of approximately 37GBq (1Ci) of 131I MIBG, five years later. The reduction in uptake is evident. Before therapy, this patient was incapacitated with symptoms and could not work. After therapy he resumed full-time work, was taken off of all drugs and has fathered three healthy children.
