Derakhshan Jamal J, Farwell Michael D
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri.
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Nucl Med Commun. 2019 Jul;40(7):727-733. doi: 10.1097/MNM.0000000000001022.
Determine the prevalence of benign indium-111 (In) pentetreotide uptake in the pancreatic head and determine if a semi-quantitative method can be used to differentiate physiologic from pathologic uptake.
Institutional Review Board-approved, HIPAA-compliant retrospective review of 197 somatostatin receptor scintigraphy studies performed in 136 patients, from December 2012 to November 2013 at a large academic medical center. The pancreatic head uptake was visually graded and for all positive cases, two-dimensional and three-dimensional ratios of the pancreatic head to normal liver uptake were calculated. Statistical analysis using paired and two-sample t-tests was performed.
Nineteen of one hundred twenty-nine (14.7%) patients had benign In pentetreotide uptake in the pancreatic head. Seven of seven (100%) patients with neuroendocrine (NE) tumors had definite visual uptake. Uptake was 2.7× more likely benign than malignant. Using a three-dimensional region of interest (ROI) method, the pancreatic head-to-liver ratio was 0.91±0.38 (0.37-1.63) for benign uptake and 8.2±7.3 (1.79-23.6) for pathologic uptake (P<0.001). A threshold of 1.67 provided 100% accuracy for determining the presence or absence of a pancreatic head NE tumor. Using a two-dimensional ROI method, the uptake ratio was 0.88±0.37 (0.28-1.73) for benign and 7.5±6.2 (1.85-19.6) for pathologic uptake (P<0.001); a ratio threshold of 1.62 provided 97% accuracy. There was no difference between the uptake ratios at 4 and 24 h.
In pentetreotide uptake in the pancreatic head is common and more frequently benign than malignant. Using simple ROI ratiometric methods helps to differentiate benign physiologic from malignant NE tumor uptake.
确定胰腺头部铟 - 111（In）喷替肽摄取的良性患病率，并确定是否可以使用半定量方法区分生理性摄取与病理性摄取。
对2012年12月至2013年11月在一家大型学术医疗中心对136例患者进行的197项生长抑素受体闪烁显像研究进行机构审查委员会批准且符合健康保险流通与责任法案（HIPAA）的回顾性审查。对胰腺头部摄取进行视觉分级，对于所有阳性病例，计算胰腺头部与正常肝脏摄取的二维和三维比值。使用配对和两样本t检验进行统计分析。
129例患者中有19例（14.7%）胰腺头部存在良性In喷替肽摄取。7例神经内分泌（NE）肿瘤患者中有7例（100%）有明确的视觉摄取。摄取为良性的可能性是恶性的2.7倍。使用三维感兴趣区（ROI）方法，良性摄取的胰腺头部与肝脏比值为0.91±0.38（0.37 - 1.63），病理性摄取为8.2±7.3（1.79 - 23.6）（P<0.001）。阈值为1.67时，确定胰腺头部NE肿瘤的存在与否的准确率为100%。使用二维ROI方法，良性摄取的摄取比值为0.88±0.37（0.28 - 1.73），病理性摄取为7.5±6.2（1.85 - 19.6）（P<0.001）；比值阈值为1.62时准确率为97%。4小时和24小时的摄取比值无差异。
胰腺头部In喷替肽摄取常见，良性多于恶性。使用简单的ROI比例方法有助于区分良性生理性摄取与恶性NE肿瘤摄取。
