核医学影像学进展：胰腺神经内分泌肿瘤的定位与治疗。

Imaging Advancements in Nuclear Medicine: Pancreatic Neuroendocrine Tumor Localization and Treatment.

机构信息

Chelsea Palmer Stephens, MHS, R.T.(R)(N), CNMT, is director of the Master of Science in Nuclear Medicine Technology program and assistant professor for the Department of Clinical and Diagnostic Sciences at the University of Mississippi Medical Center, School of Health Related Professions in Jackson.

Asher Street Beam, DHA, R.T.(R)(MR), MRSO, is director of the Master of Science in Magnetic Resonance Imaging program and associate professor for the Department of Clinical and Diagnostic Sciences at the University of Mississippi Medical Center, School of Health Related Professions.

出版信息

Radiol Technol. 2022 May-Jun;93(5):431-436.

PMID:35508408

Abstract

BACKGROUND

This case report details a 57-year-old African American man with pancreatic neuroendocrine tumors (NETs). The patient underwent positron emission tomography (PET) imaging using gallium Ga 68 dotatate, which localized the tumors. Selected tumors were treated with 4 doses of 200 mCi of lutetium Lu 177 dotatate during a period of 8 months. At the conclusion of treatment, the patient demonstrated improvement, progressing from bedbound and confused to ambulatory and coherent. In addition, the patient stated he felt no adverse effects.

DISCUSSION

Pancreatic NETs are rare tumors affecting 0.001% of the population. These tumors are associated with various symptoms and are classified as functional or nonfunctional. Imaging modalities, such as computed tomography (CT), magnetic resonance (MR) imaging, and gallium Ga 68-labeled PET, are essential in detecting and evaluating pancreatic NETs. For patients with localized NETs, the primary treatment is surgery; however, the radiopharmaceuticals yttrium Y 90 microspheres and lutetium Lu 177 dotatate are used as therapy to treat nonresectable tumors.

CONCLUSION

Lutetium Lu 177 dotatate is used in NET cases that are deemed inoperable and for patients who are not responding to treatment. This case study demonstrates the effectiveness of combining imaging with Ga 68-labeled PET and treatment with lutetium Lu 177 dotatate. This treatment is not a cure but has been shown to improve a patient's quality of life.

摘要

背景

本病例报告详细介绍了一名 57 岁的非裔美国男性患有胰腺神经内分泌肿瘤（NETs）。患者接受了镓 Ga 68 标记的正电子发射断层扫描（PET）成像，该成像定位了肿瘤。在 8 个月的时间内，对选定的肿瘤进行了 4 次 200mCi 的镥 Lu 177 标记的 dotatate 治疗。治疗结束时，患者表现出改善，从卧床不起和困惑到能够走动和表达清晰。此外，患者表示没有感到任何不良反应。

讨论

胰腺 NETs 是一种罕见的肿瘤，影响 0.001%的人群。这些肿瘤与各种症状有关，分为功能性或非功能性。成像方式，如计算机断层扫描（CT）、磁共振（MR）成像和镓 Ga 68 标记的 PET，对于检测和评估胰腺 NETs 至关重要。对于局限性 NETs 患者，主要治疗方法是手术；然而，放射性药物钇 Y 90 微球和镥 Lu 177 标记的 dotatate 可用于治疗无法切除的肿瘤。