Abstract
Purpose
Neuroendocrine tumours (NETs) can be imaged with scintigraphy using radiolabelled somatostatin analogues. The aim of our study was to compare the value of 68Ga-DOTATOC PET and 111In-DTPAOC SPECT (Octreoscan) in the detection of NET manifestations.
Methods
Twenty-seven NET patients were prospectively examined. 68Ga-DOTATOC PET and 111In-DTPAOC SPECT were performed using standard techniques. Treatment was not applied in between. Mean and maximum standardised uptake values (SUVs) were calculated for PET findings. Tumour/non-tumour ratios were calculated for SPECT findings. Findings were compared by a region-by-region analysis and verified with histopathology, CT and MRI within 21 days.
Results
SUVs of positive lesions on 68Ga-DOTATOC PET ranged from 0.7 to 29.3 (mean SUV) and from 0.9 to 34.4 (maximum SUV). Tumour/non-tumour ratios on 111In-DTPAOC SPECT ranged from 1.8 to 7.3. In imaging lung and skeletal manifestations, 68Ga-DOTATOC PET was more efficient than 111In-DTPAOC SPECT. All discrepant lung findings and 77.8% of discrepant osseous findings were verified as true positive PET interpretations. In regional comparison of liver and brain, 68Ga-DOTATOC PET and 111In-DTPAOC SPECT were identical. In lymph nodes, the pancreas and the gastro-intestinal system, different values of the two techniques were not indicated in regional analyses. In a single patient, surgical interventions were changed on the basis of 68Ga-DOTATOC PET findings.
Conclusion
68Ga-DOTATOC PET is superior to 111In-DTPAOC SPECT in the detection of NET manifestations in the lung and skeleton and similar for the detection of NET manifestations in the liver and brain. 68Ga-DOTATOC PET is advantageous in guiding the clinical management.
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References
Ueberberg B, Tourne H, Redman A, Walz MK, Schmid KW, Mann K, et al. Differential expression of the human somatostatin receptor subtypes sst1 to sst5 in various adrenal tumors and normal adrenal gland. Horm Metab Res 2005;37 12:722–8.
Papotti M, Kuma U, Volante M, Pecchiono C, Patel YC. Immunohistochemical detection of somatostatin receptor types 1–5 in medullary carcinoma of the thyroid. Clin Endocrinol 2001;54:641–9.
Oda Y, Tanaka Y, Naruse T, Sasanabe R, Tsubamoto M, Funahashi H. Expression of somatostatin receptor and effects of somatostatin analog on pancreatic endocrine tumors. Surg Today 2002;32 8:690–4.
Papotti M, Bongiovanni M, Volante M, Allia E, Landolfi S, Helboe L, et al. Expression of somatostatin receptor types 1–5 in 81 cases of gastrointestinal and pancreatic endocrine tumors. A correlative immunohistochemical and reverse-transcriptase polymerase chain reaction analysis. Virchows Arch 2002;440 5:461–75.
Kaltsas G, Mukherjee JJ, Grossman AB. The value of radiolabeled MIBG and octreotide in the diagnosis and management of neuroendocrine tumours. Clin Endocrinol 2001;55:575–87.
Kaltsas G, Rockall A, Papadogias D, Reznek R, Grossman AB. Recent advances in radiological and radionuclide imaging and therapy of neuroendocrine tumours. Eur J Endocrinol 2004;151:15–27.
Gibril F, Reynolds JC, Doppmann JL, Chen CC, Venzon DJ, Termanini B, et al. Somatostatin receptor scintigraphy: Its sensitivity compared with that of other imaging methods in detecting primary and metastatic gastrinomas: a prospective study. Ann Int Med 1996;125 1:26–34.
Koukouraki S, Strauss LG, Georgoulias V, Eisenhut M, Maecke HR, Haberkorn U, et al. Comparison of the pharmacokinetics of 68Ga-DOTATOC and 18F-FDG in patients with metastatic neuroendocrine tumours (NET) scheduled for 90Y -DOTATOC therapy. Eur J Nucl Med Mol Imaging 2006;33 4:460–6.
Reubi JC, Schär JC, Waser B, Wenger S, Heppeler A, Schmitt JS, et al. Affinity profiles for human somatostatin receptor subtypes SST1–SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med Mol Imaging 2000;27:273–82.
Kowalski J, Henze M, Schumacher J, Maecke HR, Hofmann H, Haberkorn U. Evaluation of positron emission tomography imaging using 68Ga DOTA-Phe1-Tyr3-octreotide in comparison to [111In]-DTPAOC SPECT. First results in patients with neuroendocrine tumors. Mol Imag Biol 2003;5 1:42–8.
Hofmann M, Maecke H, Borner R, Weckesser E, Schoffski P, Oei L, et al. Biokinetics and imaging with the somatostatin receptor PET radioligand 68Ga-DOTATOC: Preliminary data. Eur J Nucl Med Mol Imaging. 2001;28 12:1751–7.
Heppeler A, Froidevaux S, Mäcke HR. Radiometal-labeled macrocyclic chelator-derivatised somatostatin analogue with superb tumour-targeting properties and potential for receptor-mediated internal radiotherapy. Chem Eur J 1999;5:1974–81.
Schuhmacher J, Maier-Borst W. A new 68Ge/68Ga radioisotope generator system for production of 68Ga in dilute HCl. Appl Radiat Isotopes 1981;32:31–6.
Shi W, Johnston CF, Buchanan KD, Ferguson WR, Laird JD, Crothers JG, et al. Localization of neuroendocrine tumours with [111In]-DTPA-octreotide scintigraphy (Octreoscan): a comparative study with CT and MRI imaging. QJM 1998;91 4:295–301.
Martin WH, Delbeke D, Patton JA, Sandler MP. Detection of malignancies with SPECT versus PET, with 2-(fluorine-18)fluoro-2-deoxy-D-glucose. Radiology 1996;198 1:225–31.
Arita T, Kuramitsu T, Kawamura M, Matsumoto T, Matsunaga N, Sugi K, et al. Bronchogenic carcinoma: incidence of metastases to normal sized lymph nodes. Thorax 1995;50:1267–9.
Einstein DM, Singer AA, Chilcote WA, Desai RK. Abdominal lymphadenopathy: spectrum of CT findings. RadioGraphics 1991;11:457–72.
Gross BH, Glatzer GM, Orringer MB. Bronchogenic carcinoma metastatic to normal-sized nodes: frequency and significance. Radiology 1988;166:71–4.
Kumar U, Sasi R, Suresh S, Patel A, Thangaraju M, Metrakos P, et al. Subtype-selective expression of the five somatostatin receptors (hSSTR1–5) in human pancreatic islet cells: a quantitative double-label immunohistochemical analysis. Diabetes 1999;48 1:77–85.
Casini Raggi C, Calabro A, Renzi D, Briganti V, Cianchi F, Messerini L, et al. Quantitative evaluation of somatostatin receptor subtype 2 expression in sporadic colorectal tumor and in the corresponding normal mucosa. Clin Cancer Res 2002;8 2:419–27.
Menzel C, Graichen S, Berner U, Risse JH, Diehl M, Doebert N, et al. Monitoring the efficacy of iodine-131-MIBG therapy using fluorine-18-FDG-PET. Acta Med Austriaca 2003;30 2:37–40.
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M. Henze and S. Engelbrecht contributed equally to this paper.
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Buchmann, I., Henze, M., Engelbrecht, S. et al. Comparison of 68Ga-DOTATOC PET and 111In-DTPAOC (Octreoscan) SPECT in patients with neuroendocrine tumours. Eur J Nucl Med Mol Imaging 34, 1617–1626 (2007). https://doi.org/10.1007/s00259-007-0450-1
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DOI: https://doi.org/10.1007/s00259-007-0450-1