Parisella M G, Chianelli M, D'Alessandria C, Todino V, Mikolajczak R, Papini E, Dierckx R A, Scopinaro F, Signore A
Department of Nuclear Medicine, S. Andrea Hospital, Second Faculty of Medicine, Sapienza University, Roma, Italy.
Q J Nucl Med Mol Imaging. 2012 Feb;56(1):90-8. Epub 2010 Nov 11.
The aim of this study was to define, retrospectively, the utility to perform (99m)Tc-EDDA/HYNIC-Tyr3-octreotide ((99m)Tc-EDDA/HYNIC-TOC) scan in patients with NET. We studied 50 consecutive patients affected by different types of NET and divided in two groups. Group 1: 34 patients with known lesions in which (99m)Tc-EDDA/HYNIC-TOC was performed for staging, characterisation or to choose the appropriate treatment. Group 2: 16 patients suspected of having NET or in follow up after surgery. Patients were injected with 370 MBq of (99m)Tc-EDDA/HYNIC-Tyr3-octreotide and whole-body and SPET images acquired 2-3 hours after injection. Overall, 29 patients (58%) had a positive scan, with a sensitivity, specificity and accuracy of 70.3%, 76.9% and 72%, respectively (78.1%, 50% and 76.5%, in group 1 and 20%, 81.2%, 62.5% in group 2). In patients from group 1 (99m)Tc-HYNIC-TOC scintigraphy showed a concordance of 68% with another imaging procedure and in 9 patients revealed a greater number of lesions. In the second group, false negative results were especially found in patients with medullary thyroid cancer with negative radiological findings and elevated calcitonin. In conclusion, (99m)Tc-EDDA/HYNIC-TOC is highly indicated for in vivo histological characterization of known NET lesions, previously identified by other imaging modalities or biopsy, to plan appropriate therapy especially for patients with inoperable disease. In patients with only biochemical suspicion of NET and in those with negative markers, this scintigraphy does not significantly modify the clinical management.
本研究的目的是回顾性地确定对神经内分泌肿瘤（NET）患者进行锝[99mTc]依地替膦二钠/巯基乙酰三肽-酪胺酸3-奥曲肽（[99mTc]EDDA/HYNIC-TOC）扫描的效用。我们研究了50例连续的不同类型NET患者，并将其分为两组。第1组：34例已知病变患者，对其进行[99mTc]EDDA/HYNIC-TOC扫描以进行分期、特征描述或选择合适的治疗方法。第2组：16例疑似患有NET或术后随访的患者。给患者注射370MBq的锝[99mTc]依地替膦二钠/巯基乙酰三肽-酪胺酸3-奥曲肽，并在注射后2 - 3小时采集全身和单光子发射计算机断层扫描（SPET）图像。总体而言，29例患者（58%）扫描结果为阳性，敏感性、特异性和准确性分别为70.3%、76.9%和72%（第1组分别为78.1%、50%和76.5%，第2组分别为20%、81.2%和62.5%）。在第1组患者中，[99mTc]HYNIC-TOC闪烁扫描与另一种成像检查的一致性为68%，在9例患者中发现了更多的病变。在第2组中，假阴性结果尤其出现在甲状腺髓样癌患者中，这些患者的影像学检查结果为阴性但降钙素升高。总之，锝[99mTc]依地替膦二钠/巯基乙酰三肽-酪胺酸3-奥曲肽非常适用于对已知的NET病变进行体内组织学特征描述，这些病变先前已通过其他成像方式或活检确定，以规划合适的治疗方案，特别是对于无法手术的疾病患者。对于仅生化检查怀疑患有NET的患者以及标志物为阴性的患者，这种闪烁扫描对临床管理没有显著影响。
