Fanti Stefano, Ambrosini Valentina, Tomassetti Paola, Castellucci Paolo, Montini Giancarlo, Allegri Vincenzo, Grassetto Gaia, Rubello Domenico, Nanni Cristina, Franchi Roberto
Unità Operativa di Medicina Nucleare, Policlinico S. Orsola-Malpighi, Bologna, Italy.
Biomed Pharmacother. 2008 Dec;62(10):667-71. doi: 10.1016/j.biopha.2008.01.010. Epub 2008 Mar 3.
(18)F-FDG PET value for the assessment of neuroendocrine tumours (NET) is limited. Preliminary studies indicate that somatostatin receptor PET using (68)Ga-DOTA-peptides is more accurate for disease assessment and provide additional data on receptor status, that are crucial for targeted radionuclide therapy. At present, however, few papers investigated the role of (68)Ga-DOTA-NOC PET in NET, especially in unusual situations. The purpose of the present study was to evaluate (68)Ga-DOTA-NOC for the evaluation of NET of uncommon presentation. Patients with biopsy-proven NET were scheduled for (68)Ga-DOTA-NOC PET; we excluded from further evaluation cases with most common NET tumours (gastro-entero-pancreatic and pulmonary localization of primary lesion, MEN syndromes, medullary thyroid carcinoma, pheochromocytomas). PET results were compared with findings of conventional imaging, including CT, ultrasonography, MR and somatostatin receptor scintigraphy; finally PET results were compared with follow-up data with respect to the impact on patient management. Fourteen patients were finally enrolled; primary tumours were located at uterine level (3 cases), prostate (3 cases), ovary (1 case), kidney (1 case), breast (1 case), ear (1 case); also 3 cases of paraganglioma (at neck, abdominal and mediastinum level) and 1 case of lymphoma were included. (68)Ga-DOTA-NOC PET was positive, showing at least 1 lesion, in 6/14 cases while 5 cases turned out negative and 2 inconclusive. On a clinical basis, (68)Ga-DOTA-NOC provided additional information in comparison to conventional imaging procedures in 7/14 cases, and was considered useful in 12/14 patients, with 8 patients in which (68)Ga-DOTA-NOC PET was determinant for patient's management. Although the number of patients studied is limited, our data show that (68)Ga-DOTA-NOC can be usefully applied for the evaluation of NET of uncommon presentation; in particular very promising results were obtained in paraganglioma. On the other hand, care has to be paid when studying lesions localized at sites of physiological concentration of the tracer, and in presence of inflammation.
（18）F-FDG PET用于评估神经内分泌肿瘤（NET）的价值有限。初步研究表明，使用（68）Ga-DOTA肽的生长抑素受体PET在疾病评估方面更为准确，并能提供有关受体状态的额外数据，这些数据对于靶向放射性核素治疗至关重要。然而，目前很少有论文研究（68）Ga-DOTA-NOC PET在NET中的作用，尤其是在不常见的情况下。本研究的目的是评估（68）Ga-DOTA-NOC用于评估表现不常见的NET。经活检证实为NET的患者被安排进行（68）Ga-DOTA-NOC PET检查；我们将最常见的NET肿瘤（原发性病变位于胃肠胰和肺部、MEN综合征、甲状腺髓样癌、嗜铬细胞瘤）病例排除在进一步评估之外。将PET结果与包括CT、超声、MR和生长抑素受体闪烁显像在内的传统影像学检查结果进行比较；最后，将PET结果与随访数据进行比较，以了解其对患者管理的影响。最终纳入14例患者；原发性肿瘤位于子宫（3例）、前列腺（3例）、卵巢（1例）、肾脏（1例）、乳腺（1例）、耳部（1例）；还包括3例副神经节瘤（分别位于颈部、腹部和纵隔）和1例淋巴瘤。（68）Ga-DOTA-NOC PET检查结果为阳性，显示至少1个病灶的有6/14例，5例为阴性，2例结果不确定。从临床角度来看，与传统影像学检查相比，（68）Ga-DOTA-NOC在7/14例患者中提供了额外信息，12/14例患者认为其有用，其中8例患者的（68）Ga-DOTA-NOC PET对患者管理起决定性作用。尽管研究的患者数量有限，但我们的数据表明，（68）Ga-DOTA-NOC可有效地用于评估表现不常见的NET；特别是在副神经节瘤中获得了非常有前景的结果。另一方面，在研究位于示踪剂生理浓聚部位的病变以及存在炎症的情况下，必须谨慎。
