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Figure 16a.  Metastatic MTC in MEN 2. (a) On an ¹²³I-MIBG scintigram, increased radiotracer uptake due to multiple hepatic metastases is seen within the liver. The scan was used as a baseline image prior to initiating radionuclide therapy with ¹³¹I-MIBG. (b) On an ¹¹¹In-octreotide scintigram obtained in a different patient, multiple areas of increased radiotracer uptake are depicted within the neck, mediastinum, liver, and upper abdomen. (c) Posttreatment ¹³¹I-MIBG scintigrams obtained in the same patient as in b show increased radiotracer uptake within the liver due to residual disease.