99mTc-EDDA/HYNIC-TOC与111In-DTPA-奥曲肽用于诊断生长抑素受体表达肿瘤的患者内比较

An intrapatient comparison of 99mTc-EDDA/HYNIC-TOC with 111In-DTPA-octreotide for diagnosis of somatostatin receptor-expressing tumors.

作者信息

Gabriel Michael, Decristoforo Clemens, Donnemiller Eveline, Ulmer Hanno, Watfah Rychlinski Christine, Mather Stephen J, Moncayo Roy

机构信息

Department of Nuclear Medicine, University of Innsbruck, Innsbruck, Austria. Institute of Biostatistics, University of Innsbruck, Innsbruck, Austria. Nuclear Medicine Research Laboratory, St. Bartholomew's Hospital, London, United Kingdom.

出版信息

J Nucl Med. 2003 May;44(5):708-16.

PMID:12732671

Abstract

UNLABELLED

The aim of this study was to compare the imaging abilities of the recently developed somatostatin analog, (99m)Tc-hydrazinonicotinyl-Tyr(3)-octreotide ((99m)Tc-HYNIC-TOC [(99m)Tc-TOC]), with (111)In-diethylenediaminepentaacetic acid-D-Phe(1)-octreotide ((111)In-OCT [Octreoscan]) in patients undergoing routine somatostatin receptor (SSTR) scintigraphy.

METHODS

Forty-one patients (20 men, 21 women; age range, 29-75 y; mean age, 56.7 y) with either histologically proven or biologically and clinically suspected endocrine tumors were enrolled in the study. Four groups were distinguished: (a) patients being evaluated for the detection and localization of neuroendocrine tumors (n = 6), (b) tumor staging (n = 19), (c) patients being investigated to determine the SSTR status of tumor lesions (n = 11), and (d) patient follow-up studies (n = 5). Each patient received a mean activity of 150 MBq (111)In-OCT and 350-400 MBq (99m)Tc-TOC. Scintigraphy with (99m)Tc-TOC was performed 4 h after injection and scintigraphy with (111)In-OCT was performed 4 and 24 h after injection. SPECT studies of areas of interest were performed 4 h after injection for both tracers as well as at 24 h after injection for (111)In-OCT. The time interval between the studies using each tracer ranged from 2 to 22 d (mean interval, 9.3 d).

RESULTS

(111)In-OCT and (99m)Tc-TOC showed an equivalent scan result in 32 patients (78%), 9 cases showed discrepancies (22%), false-negative results with (111)In-OCT were seen in 6 cases (14.6%), whereas (99m)Tc-TOC was false-positive in 2 cases (4.9%). (111)In-OCT was true-negative in both cases. The false-positive findings of the (99m)Tc-TOC studies were caused by nonspecific uptake in the bowel. In 1 case, (99m)Tc-TOC correctly identified a metastasis in the lumbar spine but both scan results were false-positive because of an inflammatory process. In 21 patients with SSTR-expressing tumors, the semiquantitative region-of-interest analysis showed that (99m)Tc-TOC achieved higher tumor-to-normal tissue ratios than (111)In-OCT.

CONCLUSION

This study revealed a higher sensitivity of (99m)Tc-TOC as compared with (111)In-OCT as an imaging agent for the localization of SSTR-expressing tumors. To avoid false-positive findings with (99m)Tc-OCT due to nonspecific tracer accumulation, additional scanning at 1-2 h after injection should be done.

摘要

未标注

本研究的目的是比较最近开发的生长抑素类似物（99m）锝-肼基烟酰基-Tyr（3）-奥曲肽（（99m）Tc-HYNIC-TOC [（99m）Tc-TOC]）与（111）铟-二乙三胺五乙酸-D-苯丙氨酸（1）-奥曲肽（（111）In-OCT [奥曲肽扫描]）在接受常规生长抑素受体（SSTR）闪烁扫描的患者中的成像能力。

方法

41例患者（20例男性，21例女性；年龄范围29 - 75岁；平均年龄56.7岁），组织学证实或生物学及临床怀疑为内分泌肿瘤，纳入本研究。分为四组：（a）评估神经内分泌肿瘤检测和定位的患者（n = 6），（b）肿瘤分期（n = 19），（c）研究肿瘤病变SSTR状态的患者（n = 11），（d）患者随访研究（n = 5）。每位患者平均接受150 MBq的（111）In-OCT和350 - 400 MBq的（99m）Tc-TOC。注射后4小时进行（99m）Tc-TOC闪烁扫描，注射后4小时和24小时进行（111）In-OCT闪烁扫描。两种示踪剂注射后4小时对感兴趣区域进行SPECT研究，（111）In-OCT注射后24小时也进行SPECT研究。使用每种示踪剂的研究之间的时间间隔为2至22天（平均间隔9.3天）。

结果

（111）In-OCT和（99m）Tc-TOC在32例患者（78%）中显示出等效的扫描结果，9例出现差异（22%），（111）In-OCT有6例假阴性结果（14.6%），而（99m）Tc-TOC有2例假阳性结果（4.9%）。（111）In-OCT在这两例中均为真阴性。（99m）Tc-TOC研究的假阳性结果是由肠道非特异性摄取引起的。在1例中，（99m）Tc-TOC正确识别出腰椎转移灶，但由于炎症过程，两次扫描结果均为假阳性。在21例表达SSTR的肿瘤患者中，半定量感兴趣区域分析显示，（99m）Tc-TOC比（111）In-OCT获得更高的肿瘤与正常组织比值。