Department of Nuclear Medicine, Istanbul Medical Faculty, Istanbul University, 34390, Fatih, Istanbul, Turkey.
Ann Nucl Med. 2012 Nov;26(9):689-97. doi: 10.1007/s12149-012-0628-x. Epub 2012 Jul 17.
Pulmonary carcinoid (PC) tumors are rare neoplasms of the lung with good prognosis but diagnosis may be demanding since there is no exclusive modality alone to clearly differentiate a PC tumor. The purpose of this study is to establish the diagnostic features of somatostatin receptor scintigraphy (SRS), comparatively (where available) with 18FDG PET/CT (PET/CT) correlated with histopathologic findings.
Twenty-one patients who underwent SRS with 111In-octreotide and were diagnosed as having PC tumors were retrospectively studied. Thirteen patients were performed PET/CT. Primary tumour size, Ki-67 indexes, image analysis data of SRS and PET/CT including maximum standardized uptake values (SUVmax) together with false negative, false positive, true positive and true negative lesions were documented and discussed.
Eleven (52.4%) patients were typical (TC) and 10 (47.6%) were atypical carcinoids (AC) with mean Ki-67 indexes of 2.1 and 24%, respectively. Patients underwent SRS for solitary pulmonary nodule (SPN) characterization (n = 12) and determination of disease extension (n = 9). Overall sensitivity and specificity of SRS in the detection of primary tumour, lymph nodes (LN) and distant metastasis (DM) were 76 and 97 %, respectively, whereas, positive and negative predictive values were 95 and 86 %. PET/CT was performed for determining disease spread (n = 3) and metabolic characterization (n = 10) of SPNs. Mean SUVmax in the primary pulmonary lesion in TCs and ACs were 2.9 ± 0.8 and 7.9 ± 5.4, respectively. Nodal involvement (n = 5) and DM (n = 3) were also detected. Sensitivity and specificity of PET/CT in the detection of primary tumour, LNs and DM were 85 and 89.4 %, respectively.
SRS is useful in the diagnosis and monitoring of PC tumors when incorporated with 18FDG PET/CT as a primary staging tool particularly in the determination of disease spread.
肺类癌（PC）肿瘤是肺部罕见的肿瘤，预后良好，但由于没有单独的方法能够明确区分 PC 肿瘤，因此诊断可能具有挑战性。本研究旨在建立生长抑素受体闪烁显像（SRS）的诊断特征，将其与 18FDG PET/CT（PET/CT）进行比较（如有），并与组织病理学发现相关联。
回顾性研究了 21 例接受 111In-奥曲肽 SRS 并诊断为 PC 肿瘤的患者。其中 13 例患者进行了 PET/CT 检查。记录并讨论了原发肿瘤大小、Ki-67 指数、SRS 和 PET/CT 的图像分析数据，包括最大标准化摄取值（SUVmax）以及假阴性、假阳性、真阳性和真阴性病变。
11 例（52.4%）患者为典型类癌（TC），10 例（47.6%）为非典型类癌（AC），Ki-67 指数分别为 2.1%和 24%。患者进行 SRS 检查以确定孤立性肺结节（SPN）的特征（n=12）和疾病范围（n=9）。SRS 检测原发肿瘤、淋巴结（LN）和远处转移（DM）的总体敏感性和特异性分别为 76%和 97%，阳性和阴性预测值分别为 95%和 86%。PET/CT 用于确定 SPN 的疾病扩散（n=3）和代谢特征（n=10）。TC 和 AC 中原发性肺部病变的平均 SUVmax 分别为 2.9±0.8 和 7.9±5.4。还检测到淋巴结受累（n=5）和远处转移（n=3）。PET/CT 检测原发肿瘤、LN 和 DM 的敏感性和特异性分别为 85%和 89.4%。
SRS 结合 18FDG PET/CT 作为主要分期工具，在诊断和监测 PC 肿瘤时非常有用，特别是在确定疾病扩散方面。
