Abstract
Objective
The aim of this study was to assess the occurrence and frequency of increased physiologic uptake of 99mTc-HYNIC-TOC by the uncinate process of the pancreas in SPECT/CT images.
Methods
Forty-six scans of 41 patients were evaluated retrospectively. The uptake of 99mTc-HYNIC-TOC was considered to be physiologic in patients with normal findings at dedicated abdominal CT or MR and lack of neoplastic lesions in clinical follow-ups. The intensity of uncinate process uptake was compared to the uptake of the normal liver.
Results
Focal uptake was attributed to the presence of pancreatic NET in 5 patients. Among the 36 patients without any evidence of malignancy in CT, MR and follow-up, 7 (19.4 %) showed increased uptake in the uncinate process. The intensity of uptake was lesser in 3 (8.3 %), similar in 3 and greater than the normal liver in 1 (2.8 %) case.
Conclusion
Increased 99mTc-HYNIC-TOC uptake occurred in 19.4 % of those subjects without any evidence of neuroendocrine tumor in the uncinate process.
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References
Krenning EP, Kwekkeboom DJ, Bakker WH, Breeman WA, Kooij PP, Oei HY et al (1993) Somatostatin receptor scintigraphy with (111In-DTPA-D-Phe1)- and (123I-Tyr3)-octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med 20(8):716–731
Ambrosini V, Campana D, Bodei L, Nanni C, Castelucci P, Allegri V et al (2010) 68 Ga-DOTANOC PET-CT clinical impact in patients with neuroendocrine tumors. J Nucl Med 51(5):669–673
Castellucci P, Ucha JP, Fuccio C, Rubello D, Ambrosini V, Montini GC et al (2011) Incidence of increased 68 Ga-DOTANOC uptake in the pancreatic head in a large series of extrapancreatic NET patients studied with sequential PET/CT. J Nucl Med 52(6):886–890
Decristoforo C, Mather SJ, Cholewinski W, Donnemiller E, Riccabona G, Moncayo R (2000) 99mTc-EDDA/HYNIC-TOC: a new 99mTc-labelled radiopharmaceutical for imaging somatostatin receptor-positive tumours: first clinical results and intra-patient comparison with 111In-labelled octreotide derivatives. Eur J Nucl Med 27:1318–1325
Gabriel C, Mather SJ, Moncayo RM, Decristoforo C, Donnemiller E, Ulmer H et al (2003) An intrapatient comparison of 99mTc-EDDA/HYNIC-TOC with 111In-DTPA-octreotide for diagnosis of somatostatin receptor-expressing tumors. J Nucl Med 44(5):708–716
Kroiss A, Putzer D, Decristoforo C, Uprimny C, Warwitz B, Nilica B et al (2013) 68 Ga-DOTA-TOC uptake in neuroendocrine tumour and healthy tissue: differentiation of physiological uptake and pathological processes in PET/CT. Eur J Nucl Med 40(4):514–523
Kunikowska J, Krolicki L, Pawlak D, Zerizer I, Mikolajczak R (2012) Semiquantitative analysis and characterization of physiological biodistribution of 68 Ga-DOTATATE PET/CT. Clin Nucl Med 37:1052–1057
Wong K, Cahill JM, Frey K, Avram A (2010) Incremental value of 111-In pentetreotide SPECT/CT fusion imaging of neuroendocrine tumors. Acad Radiol 17(3):291–297
Taniyama Y, Suzuki T, Mikami Y, Moriya T, Satomi S, Sasano H (2005) Systemic distribution of somatostatin receptor subtypes in human: an immunohistochemical study. Endocr J 52(5):605–611
Mieder M, Seidl S, Buck A, Scheidhauer K, Wester HJ, Schwaiger M et al (2009) Correlation of immunohistopathological expression of somatostatin receptor 2 with standardized uptake values in 68 Ga-DOTATOC PET/CT. Eur J Nucl Med 36:48–52
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This retrospective study was approved by the institutional Ethics Review Board.
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Yamaga, L.Y.I., Neto, G.C.C., da Cunha, M.L. et al. 99mTc-HYNIC-TOC increased uptake can mimic malignancy in the pancreas uncinate process at somatostatin receptor SPECT/CT. Radiol med 121, 225–228 (2016). https://doi.org/10.1007/s11547-015-0593-2
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DOI: https://doi.org/10.1007/s11547-015-0593-2