Nakamoto Yuji, Sano Kohei, Ishimori Takayoshi, Ueda Masashi, Temma Takashi, Saji Hideo, Togashi Kaori
Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-Ku, Kyoto, 606-8507, Japan,
Ann Nucl Med. 2015 Jul;29(6):512-8. doi: 10.1007/s12149-015-0973-7. Epub 2015 Apr 18.
Positron emission tomography (PET)/computed tomography (CT) using (68)Ga-labeled 1,4,7,10-tetraazacyclododecane-N,N',N″,N‴-tetraacetic acid-D-Phe(1)-Tyr(3)-octreotide (DOTATOC) has been used to detect neuroendocrine tumors (NETs). The purpose of this study was to investigate the clinical efficacy of DOTATOC-PET/CT for detecting clinically suspected NETs when conventional imaging modalities were negative or inconclusive, in terms of additional value.
A total of 46 patients were analyzed retrospectively. Among them, 14 patients underwent a DOTATOC-PET/CT scan for detecting unknown primary tumors after histopathological confirmation of a NET at metastatic sites (group A): 7 patients for detecting metastasis or recurrence after surgery for NET because of their high hormone levels but with no recurrence detected by other imaging modalities (group B); the remaining 25 patients for detecting suspected NETs because their hormone levels were high with no history of histopathologically proven NET (group C). Additional information was assessed, according to each situation.
In group A, unknown primary tumors were suspected by DOTATOC-PET/CT in 8 of 14 patients (gastrointestinal/pancreatic NET in 7 patients, prostatic cancer in 1 patient), but prostatic cancer was not confirmed by histopathology (i.e., false positive). In group B, DOTATOC-PET/CT depicted lesions in six of seven patients, including nodal metastasis (n = 5) and liver metastasis (n = 1). In group C, DOTATOC-PET/CT did not demonstrate any abnormal foci except in one case of pancreatic NET. Additional information was obtained in 50, 86, and 4 % of cases, in groups A, B, and C, respectively.
DOTATOC-PET/CT was useful for detecting NETs, especially when recurrence or metastases were suspected because of high hormone levels after surgery for a NET. It is unlikely, however, that additional information can be acquired in patients with no history of NET simply based on high hormone levels.
使用（68）镓标记的1,4,7,10 - 四氮杂环十二烷 - N,N',N″,N‴ - 四乙酸 - D - 苯丙氨酸（1） - 酪氨酸（3） - 奥曲肽（DOTATOC）的正电子发射断层扫描（PET）/计算机断层扫描（CT）已用于检测神经内分泌肿瘤（NETs）。本研究的目的是探讨当传统成像方式为阴性或不确定时，DOTATOC - PET/CT在检测临床疑似NETs方面的临床疗效，评估其附加价值。
对46例患者进行回顾性分析。其中，14例患者在转移部位的NET经组织病理学确诊后接受DOTATOC - PET/CT扫描以检测未知原发肿瘤（A组）；7例患者因激素水平高但其他成像方式未检测到复发而接受DOTATOC - PET/CT扫描以检测NET手术后的转移或复发（B组）；其余25例患者因激素水平高且无组织病理学证实的NET病史而接受DOTATOC - PET/CT扫描以检测疑似NETs（C组）。根据每种情况评估附加信息。
在A组中，14例患者中有8例经DOTATOC - PET/CT怀疑有未知原发肿瘤（7例为胃肠道/胰腺NET，1例为前列腺癌），但前列腺癌未得到组织病理学证实（即假阳性）。在B组中，7例患者中有6例经DOTATOC - PET/CT发现病变，包括淋巴结转移（n = 5）和肝转移（n = 1）。在C组中，除1例胰腺NET外，DOTATOC - PET/CT未显示任何异常病灶。A、B、C组分别有50%、86%和4%的病例获得了附加信息。
DOTATOC - PET/CT对检测NETs有用，尤其是当NET手术后因激素水平高而怀疑有复发或转移时。然而，仅基于高激素水平，对于无NET病史的患者不太可能获得附加信息。
