Demirci Emre, Ocak Meltem, Kabasakal Levent, Araman Ahmet, Ozsoy Yildiz, Kanmaz Bedii
Department of Nuclear Medicine, Cerrahpasa Medical Faculty, Istanbul University, Turkey.
Nucl Med Commun. 2013 Aug;34(8):727-32. doi: 10.1097/MNM.0b013e328362cca6.
Recent studies have suggested that PET imaging with Ga-68-labelled DOTA-somatostatin analogues such as octreotide and octreotate is useful in diagnosing neuroendocrine tumours (NETs) and has superior value over both computed tomography and planar and SPECT somatostatin receptor scintigraphy.
The aim of the present study was to evaluate the role of Ga-68 DOTA-lanreotide (Ga-68-DOTA-LAN) in patients with somatostatin receptor (sst)-expressing tumours and to compare the results of Ga-68 DOTA-D-Phe1-Tyr3-octreotate (Ga-68-DOTA-TATE) in the same patient population.
Twelve patients with NETs who were referred to our department for somatostatin receptor scintigraphy were included in the study. There were four patients with well-differentiated neuroendocrine tumour (WDNET) grade 1, two patients with WDNET grade 2, and three patients with poorly differentiated neuroendocrine carcinoma (PDNEC) grade 3. There was also one patient with medullary thyroid cancer, one patient with meningioma and one patient with MEN-1. All patients underwent two consecutive PET imaging studies with Ga-68-DOTA-TATE and Ga-68 DOTA-LAN. All images were evaluated visually, and maximum standardized uptake value was calculated for quantitative evaluation.
On visual examination of maximum intensity projection images, GA-68 DOTA-LAN was seen to have high background activity and high bone marrow uptake. Both tracers defined 67 lesions. Ga-68 DOTA-TATE images revealed 63 (94%) clearly defined lesions, missing four lesions. In contrast, Ga-68 DOTA-LAN images defined only 23 (44%) lesions, missing 44 (56%) lesions. Thirty-two bone lesions were detected on Ga-68-DOTA-TATE images. Among them, only 11 (34%) were positive on Ga-68 DOTA-LAN images, whereas 21 (66%) were negative. When we evaluated liver, mediastinum and gastrointestinal tract lesions, Ga-68 DOTA-LAN was seen to be positive for 12 (34%) lesions and negative for 23 (66%) lesions.
Although the results are preliminary, the image quality obtained by Ga-68-DOTA-TATE seems to be superior to that obtained by Ga-68 DOTA-LAN. With its significantly higher lesion uptake and higher ability to detect lesions, Ga-68-DOTA-TATE seems to be a better radioligand compared with Ga-68-DOTA-LAN for the diagnosis of NETs.
最近的研究表明，使用镓 - 68标记的DOTA - 生长抑素类似物（如奥曲肽和奥曲肽）进行PET成像，在诊断神经内分泌肿瘤（NETs）方面很有用，并且比计算机断层扫描以及平面和SPECT生长抑素受体闪烁扫描具有更高的价值。
本研究的目的是评估镓 - 68 DOTA - 兰瑞肽（Ga - 68 - DOTA - LAN）在表达生长抑素受体（sst）的肿瘤患者中的作用，并在同一患者群体中比较镓 - 68 DOTA - D - Phe1 - Tyr3 - 奥曲肽（Ga - 68 - DOTA - TATE）的结果。
本研究纳入了12名因生长抑素受体闪烁扫描转诊至我们科室的NETs患者。其中有4名1级高分化神经内分泌肿瘤（WDNET）患者，2名2级WDNET患者，3名3级低分化神经内分泌癌（PDNEC）患者。还有1名甲状腺髓样癌患者，1名脑膜瘤患者和1名MEN - 1患者。所有患者均接受了连续两次使用Ga - 68 - DOTA - TATE和Ga - 68 DOTA - LAN的PET成像研究。所有图像均进行了视觉评估，并计算最大标准化摄取值进行定量评估。
在最大强度投影图像的视觉检查中，Ga - 68 DOTA - LAN显示背景活性高且骨髓摄取高。两种示踪剂共确定了67个病灶。Ga - 68 DOTA - TATE图像显示63个（94%）清晰定义的病灶，漏诊4个病灶。相比之下，Ga - 68 DOTA - LAN图像仅定义了23个（44%）病灶，漏诊44个（56%）病灶。在Ga - 68 - DOTA - TATE图像上检测到32个骨病灶。其中，在Ga - 68 DOTA - LAN图像上只有11个（34%）为阳性，而21个（66%）为阴性。当我们评估肝脏、纵隔和胃肠道病灶时，Ga - 68 DOTA - LAN对12个（34%）病灶为阳性，对23个（66%）病灶为阴性。
尽管结果是初步的，但Ga - 68 - DOTA - TATE获得的图像质量似乎优于Ga - 68 DOTA - LAN。Ga - 68 - DOTA - TATE具有明显更高的病灶摄取和更高的病灶检测能力，与Ga - 68 - DOTA - LAN相比，似乎是用于诊断NETs的更好的放射性配体。
