Skip to main content
SpringerLink
Log in

Impact of 111In-DTPA-octreotide SPECT/CT fusion images in the management of neuroendocrine tumours

Impatto della fusione di immagini SPECT/TC con 111In-DTPA-octreotide nel management dei tumori neuroendocrini

  • Nuclear Medicine/Medicina Nucleare
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

Somatostatin receptor scintigraphy with [111In]-diethylene triamine pentaacetate acid (DTPA)-octreotide is an accurate method for detecting neuroendocrine tumours (NETs) but often does not provide clear anatomical localisation of lesions. The aim of this study was to assess the clinical usefulness of anatomical-functional image fusion.

Materials and methods

Fifty-four patients with known or suspected NET were included in the study. Planar and single-photon-emission computed tomography (SPECT) imaging was performed using a dual-head gamma camera equipped with an integrated X-ray transmission system, and the images were first interpreted alone by two nuclear medicine physicians and then compared with SPECT/CT fusion images together with a radiologist. The improvement provided by SPECT/CT in the interpretation of SPECT data alone and any modification in patientmanagement were recorded.

Results

Fusion images improved SPECT interpretation in 23 cases, providing precise anatomical localisation of increased tracer uptake in 20 cases and disease exclusion in sites of physiological uptake in 5. In 10 patients, SPECT/CT allowed definition of the functional significance of lesions detected by diagnostic CT. SPECT/CT data modified clinical management in 14 cases by changing the diagnostic approach in 8 and the therapeutic modality in 6.

Conclusions

Our study demonstrates that image fusion is clearly superior to SPECT alone, allowing precise localisation of lesions and reducing false-positive results.

Riassunto

Obiettivo

La scintigrafia con 111In-DTPA-octreotide rappresenta un metodo accurato per la diagnosi dei tumori neuroendocrini, ma spesso non fornisce una corretta localizzazione anatomica delle lesioni. Scopo di questo studio è valutare l’utilità clinica della fusione di immagini SPECT-TC.

Materiali e metodi

Sono stati inclusi 54 pazienti con tumore neuroendocrino sospetto o noto. Le immagini planari e SPECT, ottenute utilizzando una gamma-camera a doppia testata con integrato sistema trasmissivo TC, sono state interpretate prima separatamente da due medici nucleari e poi confrontate con immagini di fusione insieme ad un radiologo, per valutare i miglioramenti apportati dalla fusione nell’interpretazione delle immagini SPECT e nella gestione del paziente.

Risultati

Le immagini di fusione hanno migliorato l’interpretazione SPECT in 23 casi, permettendo una precisa localizzazione anatomica dei siti patologici in 20 casi e l’esclusione di malattia in siti di accumulo fisiologico in 5. In 10 pazienti SPECT/TC ha permesso la definizione funzionale di lesioni evidenziate alla TC diagnostica. SPECT/TC ha modificato il management clinico in 14 pazienti, modificando l’approccio diagnostico in 8 e quello terapeutico in 6.

Conclusioni

Il nostro studio dimostra che la fusione di immagini è chiaramente superiore alla sola SPECT, permettendo una precisa localizzazione delle lesioni individuate e riducendo i risultati falsi positivi.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References/Bibliografia

  1. Bombardieri E, Maccauro M, de Deckere E et al (2001) Nuclear Medicine imaging of neuroendocrine tumours. Ann Oncol 12 [Suppl 2]:S51–S61

    Article  PubMed  Google Scholar 

  2. Rubello D, Rufini V, De Carlo E et al (2003) New perspectives in diagnosis and therapy of endocrine gastroenteropancreatic (GEP) tumors with somatostatin analogues. Minerva Endocrinol 28:259–296

    PubMed  CAS  Google Scholar 

  3. Solcia E, Kloeppel G, Sobin LH (2000) Histological typing of endocrine tumors. In: World Health Organization International Histological Classification of Endocrine Tumors, 2nd edn. Springer, Berlin Heidelberg New York, pp 56–68

    Google Scholar 

  4. Rufini V, Calcagni ML, Baum RP (2006) Imaging of neuroendocrine tumors. Semin Nucl Med 36:228–247

    Article  PubMed  Google Scholar 

  5. Gibril F, Reynolds JC, Doppman JL et al (1996) Somatostatin receptor scintigraphy: its sensitivity compared with that of other imaging methods in detecting primary and metastatic gastrinomas. Ann Intern Med 125:26–34

    PubMed  CAS  Google Scholar 

  6. Lebtahi R, Cadiot G, Sarda L et al (1997) Clinical impact of somatostatin receptor scintigraphy in the management of patients with neuroendocrine gastroenteropancreatic tumors. J Nucl Med 38:853–858

    PubMed  CAS  Google Scholar 

  7. Chiti A, Fanti S, Savelli G et al (1998): Comparison of somatostatin receptor imaging, computer tomography and ultrasound in the clinical management of neuroendocrine gastro-enteropancreatic tumours. Eur J Nucl Med 25:1396–1403

    Article  PubMed  CAS  Google Scholar 

  8. Schillaci O, Danieli R, Manni C et al (2004) Is SPECT/CT with a hybrid camera useful to improve scintigraphic imaging interpretation? Nucl Med Commun 25:705–710

    Article  PubMed  Google Scholar 

  9. Schillaci O (2005) Hybrid SPECT/CT: a new era for SPECT imaging? Eur J Nucl Med Mol Imaging 32:521–524

    Article  PubMed  Google Scholar 

  10. Gabriel M, Hausler F, Bale R et al (2005) Image fusion analysis of (99m)Tc-HYNIC-Tyr(3)-octreotide SPECT and diagnostic CT using an immobilisation device with external markers in patients with endocrine tumours. Eur J Nucl Med Mol Imaging 32:1440–1451

    Article  PubMed  Google Scholar 

  11. Patton JA, Delbeke D, Sandler MP (2000) Image fusion using an integrated, dual-head coincidence camera with X-ray tube-based attenuation maps. J Nucl Med 41:1364–1368

    PubMed  CAS  Google Scholar 

  12. Even-Sapir E, Keidar Z, Sachs J et al (2001) The new technology of combined transmission and emission tomography in evaluation of endocrine neoplasms. J Nucl Med 42:998–1004

    PubMed  CAS  Google Scholar 

  13. Kaltsas GA, Besser GM, Grossman AB (2004) The diagnosis and medical management of advanced neuroendocrine tumors. Endoc Rev 25:458–511

    Article  CAS  Google Scholar 

  14. Li S, Beheshti M (2005) The radionuclide molecular imaging and therapy of neuroendocrine tumors. Curr Cancer Drug Targets 5:139–148

    Article  PubMed  CAS  Google Scholar 

  15. Seregni E, Chiti A, Bombardieri E (1998) Radionuclide imaging of neuroendocrine tumours biological basis and diagnostic results. Eur J Nucl Med 25:639–658

    Article  PubMed  CAS  Google Scholar 

  16. Hoyer D, Bell GI, Berelowitz M et al (1995) Classification and nomenclature of somatostatin receptors. Trends Pharmacol Sci 16:86–88

    Article  PubMed  CAS  Google Scholar 

  17. Shi W, Johnston CF, Buchanan KD et al (1998) Localization of neuroendocrine tumors with 111In-DTPA-octreotide scintigraphy (Octreoscan): a comparative study with CT and MR imaging. QJM 91:295–301

    Article  PubMed  CAS  Google Scholar 

  18. Kumbasar B, Kamel IR, Tekes A et al (2004) Imaging of neuroendocrine tumors: accuracy of helical CT versus SRS. Abdom Imaging 29:696–702

    Article  PubMed  CAS  Google Scholar 

  19. Perault C, Schvartz C, Wampach H et al (1997) Thoracic and abdominal SPECT-CT image fusion without external markers in endocrine carcinomas. The Group of Thyroid Tumoral Pathology of Champagne-Ardenne. J Nucl Med 38:1234–1242

    PubMed  CAS  Google Scholar 

  20. Amthauer H, Denecke T, Rohlfing T et al (2005) Value of image fusion using single photon emission computed tomography with integrated low dose computed tomography in comparison with a retrospective voxel-based method in neuroendocrine tumours. Eur Radiol 15:1456–1462

    Article  PubMed  CAS  Google Scholar 

  21. Bocher M, Balan A, Krausz Y et al (2000) Gamma camera-mounted anatomical X-ray tomography: technology, system characteristics and first images. Eur J Nucl Med 27:619–627

    Article  PubMed  CAS  Google Scholar 

  22. Krausz Y, Keidar Z, Kogan I et al (2003) SPECT/CT hybrid imaging with 111In-pentetreotide in assessment of neuroendocrine tumours. Clin Endocrinol (Oxf) 59:565–573

    Article  Google Scholar 

  23. Ozer S, Dobrozemsky G, Kienast O et al (2004) Value of combined XCT/SPECT technology for avoiding false positive planar (123)I-MIBG scintigraphy. Nuklearmedizin 43:164–170

    PubMed  CAS  Google Scholar 

  24. Tharp K, Israel O, Hausmann J et al (2004) Impact of 131I-SPECT/CT images obtained with an integrated system in the follow-up of patients with thyroid carcinoma. Eur J Nucl Med Mol Imaging 31:1435–1442

    Article  PubMed  CAS  Google Scholar 

  25. Hillel PG, van Beek EJ, Taylor C et al (2006) The clinical impact of a combined gamma camera/CT imaging system on somatostatin receptor imaging of neuroendocrine tumours. Clin Radiol 61:579–587

    Article  PubMed  CAS  Google Scholar 

  26. Pfannenberg AC, Eschmann SM, Horger M et al (2003) Benefit of anatomical-functional image fusion in the diagnostic work-up of neuroendocrine neoplasms. Eur J Nucl Med Mol Imaging 30:835–843

    PubMed  Google Scholar 

  27. Ruf J, Steffen I, Mehl S et al (2007) Influence of attenuation correction by integrated low-dose CT on somatostatin receptor SPECT. Nucl Med Commun 28:782–788

    Article  PubMed  Google Scholar 

  28. Buchmann I, Henze M, Engelbrecht S et al (2007) Comparison of 68Ga-DOATATOC PET and 111In-DTPAOC (Octreoscan) SPECT in patients with neuroendocrine tumours. Eur J Nucl Med Mol Imaging 34:1617–1626

    Article  PubMed  CAS  Google Scholar 

  29. Gabriel M, Decristoforo C, Kendler D et al (2007) 68Ga-DOTA-Tyr3-octreotide PET in neuroendocrine tumors: comparison with somatostatin receptor scintigraphy and CT. J Nucl Med 48:508–518

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Istituto di Medicina Nucleare, Dipartimento di Bioimmagini e Scienze Radiologiche, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Roma, Italy

    P. Castaldi, V. Rufini, G. Treglia, I. Bruno, G. Perotti, G. Stifano, B. Barbaro & A. Giordano

Authors
  1. P. Castaldi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. Rufini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Treglia
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. I. Bruno
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. Perotti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. G. Stifano
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. B. Barbaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. Giordano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. Castaldi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Castaldi, P., Rufini, V., Treglia, G. et al. Impact of 111In-DTPA-octreotide SPECT/CT fusion images in the management of neuroendocrine tumours. Radiol med 113, 1056–1067 (2008). https://doi.org/10.1007/s11547-008-0319-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-008-0319-9

Keywords

Parole chiave

Search

Navigation