Endocrine Unit, Department of Pathophysiology, National University of Athens, Mikras Asias 75, Athens, Greece.
J Endocrinol Invest. 2010 Dec;33(11):794-9. doi: 10.1007/BF03350344. Epub 2010 Mar 22.
Many neuroendocrine tumors (NET) are small and may escape localization by conventional imaging techniques. In such cases, 11C-5-hydroxy-tryptophan (11C-5-HTP) positron emission tomography (PET) has been tested as an additional diagnostic tool. Nine patients with clinically, biochemically and/or histologically confirmed NET and negative computerized tomography (CT) or magnetic resonance imaging (MRI), and 111In-pentetreotide (Octreoscan) scintigraphy underwent imaging with 11C-5-HTP-PET/CT in order to: 1) detect the primary tumor lesion in three patients; 2) detect residual disease in two patients with appendiceal carcinoid, one with rectal carcinoid, one with midgut carcinoid, and one with ectopic ACTH secretion (EAS) due to residual pulmonary carcinoid; and 3) restage a patient with medullary thyroid carcinoma (MTC) and hepatic metastases. 11C-5-HTP-PET/CT detected lesions in the mediastinum in a patient with EAS due to a pulmonary carcinoid, further hepatic metastases in a patient with carcinoid syndrome (CS) from a NET of unknown primary, further hepatic metastases in the patient with MTC, and hepatic metastases in the patient with midgut carcinoid. The 11C-5-HTP-PET/CT findings contributed to radical cure of the patient with recurrent EAS, and pointed towards bilateral adrenalectomy in the patient with EAS without evident primary tumor. In addition, 11C-5- HTP-PET/CT directed towards combined surgical and medical treatment in the patient with CS and multiple rather than single hepatic metastases and in the patient with midgut carcinoid, and towards continuation of medical treatment in the patient with MTC. 11C-5-HTP-PET/CT is a useful imaging technique, providing additional information for the diagnosis, staging and decision-making regarding management of patients with NET.
许多神经内分泌肿瘤（NET）体积较小，常规影像学技术可能无法定位。在这种情况下，11C-5-羟基色氨酸（11C-5-HTP）正电子发射断层扫描（PET）已被作为一种额外的诊断工具进行测试。9 名经临床、生化和/或组织学证实的 NET 患者，计算机断层扫描（CT）或磁共振成像（MRI）结果阴性，且 111In-喷曲肽（奥曲肽扫描）闪烁显像结果阴性，进行了 11C-5-HTP-PET/CT 成像，目的是：1）检测 3 名患者的原发性肿瘤病灶；2）检测 2 名阑尾类癌、1 名直肠类癌、1 名中肠类癌和 1 名由于残留肺类癌引起的异位 ACTH 分泌（EAS）患者的残留疾病；3）对 1 名有髓样甲状腺癌（MTC）和肝转移的患者进行分期。11C-5-HTP-PET/CT 在一名因肺类癌引起 EAS 的患者的纵隔中检测到病灶，在一名有类癌综合征（CS）的 NET 患者中进一步检测到肝转移，在一名有 MTC 的患者中进一步检测到肝转移，在一名有中肠类癌的患者中检测到肝转移。11C-5-HTP-PET/CT 的发现有助于根治复发性 EAS 患者，并指出在没有明显原发性肿瘤的 EAS 患者中进行双侧肾上腺切除术。此外，11C-5-HTP-PET/CT 为 CS 患者和多发性而非单发肝转移患者以及中肠类癌患者提供了联合手术和药物治疗的方向，并为 MTC 患者提供了继续药物治疗的方向。11C-5-HTP-PET/CT 是一种有用的成像技术，为 NET 患者的诊断、分期和管理决策提供了额外的信息。
