Gómez Milagros, Ferrando Rodolfo, Vilar Javier, Hitateguy Renzo, López Belkis, Moreira Ernesto, Kapitán Miguel, De Lima Fabio, Agüero Belkis, Gabriela Villegas María, Urdaneta Nelson, Gutiérrez Enrique, Battegazzore Alejandro, Bayardo Karina, Silveira Andrés, Lago Graciela, Páez Antonio
Consultorio de Medicina Nuclear Ferrari-Ferrando-Páez, Montevideo, Uruguay.
Acta Gastroenterol Latinoam. 2010 Dec;40(4):332-8.
It has been demonstrated that scintigraphy with somatostatin analogues is useful for the diagnosis, staging and follow up of patients with neuroendocrine tumors from the gastrointestinal tract (NET-GIT). Some studies suggest that the use of 99mTc-Hydrazinonicotinyl-Tyr3-octreotide (99mTc-HYNIC-TOC) yields similar diagnostic results than the use of 111In-DTPA-octreotide.
To determine the clinical value of scintigraphy using 99mTc-HYNIC-TOC for the detection of primary and secondary lesions in patients with NET-GIT.
From September 2004 to May 2009, 32 patients (17 women, age range 18 to 82 years old) with histologically proven or clinically suspected NET-GIT underwent scintigraphy using 99mTc-HYNIC-TOC Patients underwent a whole body scan, with additional static images of abdomen and pelvis, followed by SPECT at 4-hrs post injection of 925 MBq of the tracer. Patients underwent clinical, imaging and histopathology follow-up during 3 to 18 months.
Histopathology demonstrated carcinoid tumor in 20 patients, insulinoma in 2, gastrinoma in 2 and non-specific NET-GIT in 6. Total sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 87%, 100%, 100%, 89% and 94%, respectively. To detect the primary lesion, the values were 94%, 100% 100%, 94% and 97%, respectively and to detect secondary lesions, 79%, 100%, 100%, 86% and 91%, respectively.
99mTc-HYNIC-TOC is a specific somatostatin analog, with high affinity to receptor subtype SST-2, widely available and affordable by Latin American countries. It has a good performance to be used for diagnosis, staging and follow-up of patients with NET-GIT.
已证实，使用生长抑素类似物进行闪烁扫描对胃肠道神经内分泌肿瘤（NET - GIT）患者的诊断、分期及随访有用。一些研究表明，使用99mTc - 肼基烟酰基 - 酪氨酰3 - 奥曲肽（99mTc - HYNIC - TOC）产生的诊断结果与使用111In - DTPA - 奥曲肽相似。
确定使用99mTc - HYNIC - TOC进行闪烁扫描对NET - GIT患者原发性和继发性病变检测的临床价值。
2004年9月至2009年5月，32例经组织学证实或临床怀疑为NET - GIT的患者（17例女性，年龄范围18至82岁）接受了使用99mTc - HYNIC - TOC的闪烁扫描。患者进行全身扫描，并对腹部和骨盆进行额外的静态图像采集，然后在注射925 MBq示踪剂后4小时进行单光子发射计算机断层扫描（SPECT）。患者在3至18个月内接受临床、影像学和组织病理学随访。
组织病理学显示，20例为类癌肿瘤患者，2例为胰岛素瘤患者，2例为胃泌素瘤患者以及6例为非特异性NET - GIT患者。总敏感性、特异性、阳性预测值、阴性预测值和准确性分别为87%、100%、100%、89%和94%。检测原发性病变时，这些值分别为94%、100%、100%、94%和97%；检测继发性病变时，分别为79%、100%、100%、86%和91%。
99mTc - HYNIC - TOC是一种特异性生长抑素类似物，对受体亚型SST - 2具有高亲和力，拉丁美洲国家广泛可得且价格低廉。它在用于NET - GIT患者的诊断、分期和随访方面表现良好。
