Ameri P, Gatto F, Arvigo M, Villa G, Resmini E, Minuto F, Murialdo G, Ferone D
Department of Internal Medicine, University of Genoa, Genoa, Italy.
J Endocrinol Invest. 2007 Nov;30(10):889-902. doi: 10.1007/BF03349233.
Somatostatin (SS) receptor scintigraphy is useful for the diagnosis of lesions with high density of SS receptors, and above all neuroendocrine tumors. For several years, only indium-labeled octreotide has been applied to visualise in vivo tissues with SS receptor overexpression. Radiolabeled octreotide became the gold standard for the detection of neuroendocrine tumors. More recently, however, several new SS analogues with varying affinity for SS receptor subtypes have been developed, and different radionuclides as radiolabels have been introduced. Moreover, significant improvements have been made by the introduction of hybrid machines, such as single photon emission computed tomography/ computed tomography (SPECT/CT) or positron emission tomography (PET)/CT that enable to perform whole-body imaging quickly and with high anatomical resolution in several body areas, including the chest. The development of more specific radiopharmaceuticals, together with the modern technique of imaging, may provide excellent quality images with high contrast, allowing to depict very small lesions and making them easy to interpret. Indeed, in the management of SS receptor-positive lesions, the contribution of nuclear medicine is essential in several clinical settings, such as initial diagnosis, disease staging, follow-up, treatment planning, and treatment monitoring. In addition, the tracer uptake might be used as a prognostic parameter and as a predictor of treatment response. In the chest, apart in (neuro)endocrine tumors, SS receptors have been demonstrated in granulomatous diseases, like sarcoidosis and other immune-mediated disorders, such as anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis. In this paper we review and discuss the role of SS receptor scintigraphy in diagnosis, staging or follow- up of thoracic SS receptor-positive lesions.
生长抑素（SS）受体闪烁扫描术对于诊断具有高密度SS受体的病变很有用，尤其是神经内分泌肿瘤。多年来，只有铟标记的奥曲肽被用于在体内可视化过表达SS受体的组织。放射性标记的奥曲肽成为检测神经内分泌肿瘤的金标准。然而，最近已经开发出几种对SS受体亚型具有不同亲和力的新型SS类似物，并引入了不同的放射性核素作为放射性标记。此外，通过引入混合成像设备，如单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）或正电子发射断层扫描（PET）/CT，实现了在包括胸部在内的多个身体部位快速进行全身成像且具有高解剖分辨率，从而取得了显著进展。更具特异性的放射性药物的开发，连同现代成像技术，可能提供具有高对比度的高质量图像，能够描绘非常小的病变并使其易于解读。实际上，在SS受体阳性病变的管理中，核医学在多种临床情况下都至关重要，如初始诊断、疾病分期、随访、治疗规划和治疗监测。此外，示踪剂摄取可作为预后参数和治疗反应的预测指标。在胸部，除了（神经）内分泌肿瘤外，在结节病等肉芽肿性疾病以及抗中性粒细胞胞浆抗体（ANCA）相关血管炎等其他免疫介导疾病中也已证实存在SS受体。在本文中，我们回顾并讨论了SS受体闪烁扫描术在胸部SS受体阳性病变的诊断、分期或随访中的作用。
