镓-68 DOTA-TATE与镓-68 DOTA-NOC PET/CT成像在分化型甲状腺癌中的评估与比较

Evaluation and comparison of Ga-68 DOTA-TATE and Ga-68 DOTA-NOC PET/CT imaging in well-differentiated thyroid cancer.

作者信息

Ocak Meltem, Demirci Emre, Kabasakal Levent, Aygun Aslan, Tutar Rumeysa O, Araman Ahmet, Kanmaz Bedii

机构信息

aDepartment of Pharmaceutical Technology, Faculty of Pharmacy bDepartment of Nuclear Medicine, Cerrahpasa Medical Faculty cDepartment of Physical Chemistry, Faculty of Sciences, Istanbul University, Istanbul, Turkey.

出版信息

Nucl Med Commun. 2013 Nov;34(11):1084-9. doi: 10.1097/MNM.0b013e328364eaab.

DOI:10.1097/MNM.0b013e328364eaab

PMID:23939265

Abstract

BACKGROUND

Somatostatin receptor (Sstr) scintigraphy with radiolabelled somatostatin analogues has been used extensively for the diagnosis and therapy of Sstr-expressing tumours. It has been shown that well-differentiated thyroid cancer (WDTC) cells have a high expression of Sstr2, Sstr3 and Sstr5. Hence, WDTC cells could be an ideal target for the evaluation of lesion uptake of Ga-68 DOTA-1-NaI3-octreotide (DOTA-NOC), which has a high affinity not only to Sstr2 but also to Sstr3 and Sstr5. The aim of the present study was to evaluate the value of Ga-68 DOTA-NOC as a target for Sstr2-expressing, Sstr3-expressing and Sstr5-expressing tumours in WDTC patients and to compare the results with those of Ga-68 DOTA-TATE in the same patient population.

METHOD

Thirteen patients with WDTC were included in our study: nine with papillary thyroid cancer, three with Hurthle cell carcinoma and one with follicular thyroid carcinoma. All patients had elevated serum thyroglobulin levels and negative post-therapeutic I-131 whole-body scans, which were obtained after the last radioiodine treatment. All patients had undergone two consecutive PET imaging studies with Ga-68 DOTA-D-Phe1-Tyr3-octreotate (DOTA-TATE) and Ga-68 DOTA-NOC, respectively. All images were evaluated visually, and maximum standardized uptake values were calculated.

RESULTS

Both Ga-68 DOTA-TATE and Ga-68 DOTA-NOC PET images gave comparable results. Among the 13 patients, imaging with both Ga-68 DOTA-TATE and Ga-68 DOTA-NOC gave negative results in five (38%) patients and positive results in eight (62%) patients. A total of 45 lesions were identified on Ga-68 DOTA-TATE images and 42 on Ga-68 DOTA-NOC images; three lesions were missed. Lesion uptake was significantly higher on Ga-68 DOTA-TATE images. Maximum standardized uptake values of Ga-68 DOTA-TATE and Ga-68 DOTA-NOC were 12.9±9.1 and 6.3±4.1 (n=54, P<0.001), respectively.

CONCLUSION

Our study suggested that Ga-68 DOTA-TATE has a higher lesion uptake even in WDTC patients and may have potential advantage over Ga-68 DOTA-NOC.

摘要

背景

使用放射性标记的生长抑素类似物进行生长抑素受体（Sstr）闪烁扫描已广泛应用于表达Sstr的肿瘤的诊断和治疗。研究表明，分化良好的甲状腺癌（WDTC）细胞高表达Sstr2、Sstr3和Sstr5。因此，WDTC细胞可能是评估镓-68 DOTA-1-NaI3-奥曲肽（DOTA-NOC）病变摄取的理想靶点，DOTA-NOC不仅对Sstr2具有高亲和力，而且对Sstr3和Sstr5也具有高亲和力。本研究的目的是评估镓-68 DOTA-NOC作为WDTC患者中表达Sstr2、Sstr3和Sstr5的肿瘤的靶点的价值，并将结果与同一患者群体中镓-68 DOTA-TATE的结果进行比较。

方法

13例WDTC患者纳入本研究：9例为甲状腺乳头状癌，3例为嗜酸性细胞癌，1例为甲状腺滤泡癌。所有患者血清甲状腺球蛋白水平升高，且在最后一次放射性碘治疗后进行的治疗后I-131全身扫描均为阴性。所有患者分别接受了两次连续的PET成像研究，分别使用镓-68 DOTA-D-苯丙氨酸1-酪氨酸3-奥曲肽（DOTA-TATE）和镓-68 DOTA-NOC。所有图像均进行视觉评估，并计算最大标准化摄取值。

结果

镓-68 DOTA-TATE和镓-68 DOTA-NOC的PET图像结果相当。在13例患者中，镓-68 DOTA-TATE和镓-68 DOTA-NOC成像均为阴性结果的有5例（38%），阳性结果的有8例（62%）。镓-68 DOTA-TATE图像上共识别出45个病变，镓-68 DOTA-NOC图像上识别出42个病变；3个病变漏诊。镓-68 DOTA-TATE图像上的病变摄取明显更高。镓-68 DOTA-TATE和镓-68 DOTA-NOC的最大标准化摄取值分别为12.9±9.1和6.3±4.1（n = 54，P<0.001）。