Lee Inki, Paeng Jin Chul, Lee Soo Jin, Shin Chan Soo, Jang Jin-Young, Cheon Gi Jeong, Lee Dong Soo, Chung June-Key, Kang Keon Wook
Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Nucl Med Mol Imaging. 2015 Dec;49(4):284-90. doi: 10.1007/s13139-015-0356-y. Epub 2015 Aug 26.
In-pentetreotide has been used for neuroendocrine tumors expressing somatostatin receptors. Recently, (68)Ga-DOTATOC PET has been used with the advantage of high image quality. In this study, we compared quantitative indices between (111)In-pentetreotide SPECT/CT and (68)Ga-DOTATOC PET/CT.
Thirteen patients diagnosed with neuroendocrine tumors were prospectively recruited. Patients underwent (111)In-pentetreotide scans with SPECT/CT and (68)Ga-DOTATOC PET/CT before treatment. The number and location of lesions were analyzed on both imaging techniques to compare lesion detectability. Additionally, the maximal uptake count of each lesion and mean uptake count of the lungs were measured on both imagings, and target-to-normal lung ratios (TNR) were calculated as quantitative indices.
Among 13 patients, 10 exhibited lesions with increased uptake on (111)In-pentetreotide SPECT/CT and/or (68)Ga-DOTATOC PET/CT. Scans with SPECT/CT detected 19 lesions, all of which were also detected on PET/CT. Moreover, 16 additional lesions were detected on PET/CT (6 in the liver, 9 in the pancreas and 1 in the spleen). PET/CT exhibited a significantly higher sensitivity than SPECT/CT (100 % vs. 54 %, P < 0.001). TNR was significantly higher on PET/CT than on SPECT/CT (99.9 ± 84.3 vs. 71.1 ± 114.9, P < 0.001) in spite of a significant correlation (r = 0.692, P = 0.01).
Ga-DOTATOC PET/CT has a higher diagnostic sensitivity than (111)In-pentetreotide scans with SPECT/CT. The TNR on PET/CT is higher than that of SPECT/CT, which also suggests the higher sensitivity of PET/CT. (111)In-pentetreotide SPECT/CT should be used carefully if it is used instead of (68)Ga-DOTATOC PET/CT.
铟-五肽胃泌素已用于表达生长抑素受体的神经内分泌肿瘤。最近,(68)镓-奥曲肽PET因其图像质量高的优势而被使用。在本研究中,我们比较了铟-111标记的五肽胃泌素单光子发射计算机断层扫描/计算机断层扫描((111)In-pentetreotide SPECT/CT)和(68)镓-奥曲肽正电子发射断层扫描/计算机断层扫描((68)Ga-DOTATOC PET/CT)之间的定量指标。
前瞻性招募了13例诊断为神经内分泌肿瘤的患者。患者在治疗前接受了铟-111标记的五肽胃泌素SPECT/CT扫描和(68)镓-奥曲肽PET/CT扫描。对两种成像技术上的病变数量和位置进行分析,以比较病变的可检测性。此外,在两种成像上测量每个病变的最大摄取计数和肺部的平均摄取计数,并计算靶肺比(TNR)作为定量指标。
13例患者中,10例在铟-111标记的五肽胃泌素SPECT/CT和/或(68)镓-奥曲肽PET/CT上表现为摄取增加的病变。SPECT/CT扫描检测到19个病变,所有这些病变在PET/CT上也被检测到。此外,PET/CT上还检测到16个额外的病变(肝脏6个、胰腺9个、脾脏1个)。PET/CT的敏感性显著高于SPECT/CT(100%对54%,P<0.001)。尽管存在显著相关性(r=0.692,P=0.01),但PET/CT上的TNR显著高于SPECT/CT(99.9±84.3对71.1±114.9,P<0.001)。
(68)镓-奥曲肽PET/CT比铟-111标记的五肽胃泌素SPECT/CT具有更高的诊断敏感性。PET/CT上的TNR高于SPECT/CT,这也表明PET/CT具有更高的敏感性。如果用铟-111标记的五肽胃泌素SPECT/CT代替(68)镓-奥曲肽PET/CT,应谨慎使用。