锝[99mTc]标记的HYNIC-TOC SPECT/CT在胰腺神经内分泌肿瘤诊断及监测中的临床应用

Clinical application of Tc-HYNIC-TOC SPECT/CT in diagnosing and monitoring of pancreatic neuroendocrine neoplasms.

作者信息

Xu Junyan, Li Yi, Xu Xiaoping, Zhang Jiangang, Zhang Yingjian, Yu Xianjun, Huang Dan

机构信息

Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Xuhui district, Shanghai, 200032, China.

Center for Biomedical Imaging, Fudan University, Shanghai, China.

出版信息

Ann Nucl Med. 2018 Aug;32(7):446-452. doi: 10.1007/s12149-018-1266-8. Epub 2018 Jun 20.

DOI:10.1007/s12149-018-1266-8

PMID:29926342

Abstract

OBJECTIVE

Our aim of this research was to determine the value of SPECT/CT with Tc-HYNIC-TOC for evaluation of the pancreatic masses which were suspected as neuroendocrine neoplasms and follow-up of patients with pancreatic neuroendocrine neoplasms.

METHODS

We retrospectively analyzed 184 patients who performed Tc-HYNIC-TOC SPECT/CT. All the patients were divided into two groups: one for assessment of diagnostic efficiency for pancreatic suspected masses (n = 140) and another for monitoring recurrence after surgery (n = 44). The image findings acquired at 2 h postinjection were compared to final diagnoses from pathological results and clinical follow-up. Then, the correlation between ratios of tumor-to-background (TBR) and tumor grade was analyzed.

RESULTS

In group 1, 95/140 (67.9%) patients were confirmed as neuroendocrine neoplasms including 85 neuroendocrine tumors and 10 neuroendocrine carcinomas. Patient-based analysis showed that the sensitivity, specificity and accuracy of diagnosing neuroendocrine neoplasms with SPECT/CT were 81.1, 84.4 and 82.1%. There was significant difference of TBRs among G1, G2 and G3 (F = 3.175, P = 0.048). In group 2, 22/44 (50.0%) patients occurred metastasis mainly in liver. The sensitivity, specificity and accuracy of monitoring recurrence were 87.0, 100 and 93.2%.

CONCLUSIONS

Tc-HYNIC-TOC SPECT/CT is a reliable method of diagnosing and monitoring of pancreatic neuroendocrine neoplasms, especially neuroendocrine tumors.

摘要

目的

本研究旨在确定Tc-HYNIC-TOC SPECT/CT对疑似神经内分泌肿瘤的胰腺肿块评估及胰腺神经内分泌肿瘤患者随访的价值。

方法

我们回顾性分析了184例行Tc-HYNIC-TOC SPECT/CT检查的患者。所有患者分为两组：一组用于评估胰腺疑似肿块的诊断效率（n = 140），另一组用于监测术后复发（n = 44）。将注射后2小时获得的图像结果与病理结果及临床随访的最终诊断进行比较。然后，分析肿瘤与本底比值（TBR）与肿瘤分级之间的相关性。

结果

在第1组中，95/140（67.9%）例患者被确诊为神经内分泌肿瘤，包括85例神经内分泌瘤和10例神经内分泌癌。基于患者的分析显示，SPECT/CT诊断神经内分泌肿瘤的敏感性、特异性和准确性分别为81.1%、84.4%和82.1%。G1、G2和G3组之间的TBR存在显著差异（F = 3.175，P = 0.048）。在第2组中，22/44（50.0%）例患者发生转移，主要转移至肝脏。监测复发的敏感性、特异性和准确性分别为87.0%、100%和93.2%。