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chromaffin cell tumour ; 99mTc-EDDA/HYNIC-TATE ; somatostatin receptor scintgraphy ; 111In-Octreoscan ; gastroenetropancreatic neuroendocrine tumours
Abstract:
Somatostatin receptor scintigraphy (SRS) is widely used in imaging of gastroenteropancreatic neuroendocrine tumours (GEP-NET). In this study the usefulness of 99mTc-EDDA/HYNIC-TATE was analysed in detection of GEP-NET and pheochromocytoma in comparison to 111In-Octreoscanem and 131I-MIBG. Sensitivity and specificity of SRS and CT were also compared. 93 patients were examined (51.2±16.2 y); 77 with GEP-NET (50 with carcinoid and 27 with GEP-NET of pancreas) and 16 with pheochromocytoma. SRS with 99mTc-EDDA/HYNIC-TATE (740 MBq; WB- 10 min, 4, 24h; SPECT- 4h) and abdomen CT were performed in all patients. In 15 patients with GEP-NET 111In-Octreoscan and in patients with pheochromocytoma 131I-MIBG scintigraphy was performed. Focal lesions were better visible in 99mTc-EDDA/HYNIC-TATE SRS and target/non-target ratios were higher for hepatic and abdominal lesions. 99mTc-EDDA/HYNIC-TATE SRS comparing to CT was more sensitive in detection of primary lesions and recurrences of GEP-NET (81.4% vs. 58.1%, p=0.01) and of carcinoid (78.3% vs. 47.8%, p=0.02) and GEP-NET hepatic metastases (100.0% vs. 78.9%, p=0.03). In patients with pheochromocytoma adrenal lesions presented higher target/non-target ratios in 131I-MIBG scintigraphy but these ratios for metastases were higher in 99mTc-EDDA/HYNIC-TATE SRS. Sensitivity of SRS was lower than CT in adrenal lesions imaging (68.7% vs. 93.7%, p<0.05). ; High quality images obtained with 99mTc-EDDA/HYNIC-TATE make it an attractive alternative to 111In-Octreoscan in diagnosis of GEP-NET. It can also play an important role in visualization of pheochromocytoma metastases.