Department of Nuclear Medicine, University Clinical Hospital No. 1, Pomeranian Medical University in Szczecin, Poland.
Department of Nuclear Medicine, Pomeranian Medical University in Szczecin, Poland.
Nucl Med Rev Cent East Eur. 2024;27(0):31-35. doi: 10.5603/nmr.99794.
Neuroendocrine tumours (NETs) are a group of cancers that can produce hormones and other metabolically active compounds. The majority of NETs have specific tissue characteristics, such as the expression of somatostatin receptors (SSTR). Metabolic testing with [99mTc]Tc-EDDA/HYNIC-Tyr3-octreotide ([99mTc]Tc-EDDA/HYNIC-TOC) can be used in patients with NETs to visualize the presence of receptors in different locations of pathological lesions, including the skeletal system. The study aimed to calculate the body weight maximum standardized uptake value (SUVbwmax) of pathological bone lesions and healthy bone tissues, estimate the size of lesions, and identify a relationship between the SUVbwmax of the bone tissues, age and body mass of the study participants.
The somatostatin receptor scintigraphies (SRS) with [99mTc]Tc-EDDA/HYNIC-TOC were carried out at the Department of Nuclear Medicine, University Clinical Hospital No. 1, Pomeranian Medical University (PMU) in Szczecin from 2019 to 2022. Whole body and single photon emission computed tomography/computed tomography (SPECT/CT) scans were performed four hours after the injection of 700-800 MBq of [99mTc]Tc-EDDA/HYNIC-TOC in 344 patients with neuroendocrine tumours of various primary lesion locations. In 19 patients, who showed foci of increased radiopharmaceutical accumulation in bone location, the SUVbwmax was measured. The SUVbwmax of pathological bone lesions and healthy tissues were determined on SPECT/CT cross-sectional images using Xeleris 4 software.
The total number of foci with increased SSTR expression in bone regions seen on scintigraphic images was 89. Among them, 32 bone lesions were visible on the corresponding CT scans. The mean SUVbwmax of these lesions was 31.39 [standard deviation (SD) 34.31]. For the other 57 lesions that were not visible on corresponding CT scans, the mean SUVbwmax was 19.12 (SD 24.24). The smallest bone lesion detected on the scintigram and visible on the corresponding CT location was 5 mm × 5 mm, measured in cross-section, and was located in the Th8 vertebral body; the largest, measuring 20 mm × 22 mm, was detected in the L3 vertebral body. The SUVbwmax of these lesions was 24.70 and 142.40, respectively.
Bone lesions seen on SPECT/CT in [99mTc]Tc-EDDA/HYNIC-TOC scintigraphy can be quantitatively analysed using the SUV index. Even a very small pathological bone lesion can be detected on [99mTc]Tc-EDDA/HYNIC-TOC scintigraphy. It was shown that in cases where bone lesions were visible on CT scans, the SUVbwmax of bone tumour lesions was higher than when lesions were not visible on CT. Body mass does not affect the SUVbwmax of bone lesions. SUVbwmax of healthy bone tissue decreased with age.
神经内分泌肿瘤（NET）是一组能够产生激素和其他代谢活性化合物的癌症。大多数 NET 具有特定的组织特征，例如生长抑素受体（SSTR）的表达。用 [99mTc]Tc-EDDA/HYNIC-Tyr3-奥曲肽 ([99mTc]Tc-EDDA/HYNIC-TOC) 进行代谢测试可用于 NET 患者，以可视化病理病变不同部位受体的存在，包括骨骼系统。该研究旨在计算病理性骨病变和健康骨组织的体重最大标准化摄取值 (SUVbwmax)，估计病变的大小，并确定骨组织 SUVbwmax 与研究参与者的年龄和体重之间的关系。
2019 年至 2022 年，在什切青波美拉尼亚医科大学第一临床医院核医学系进行了 [99mTc]Tc-EDDA/HYNIC-TOC 生长抑素受体闪烁显像 (SRS)。在 344 名患有各种原发性病变位置神经内分泌肿瘤的患者中，在注射 700-800MBq [99mTc]Tc-EDDA/HYNIC-TOC 后 4 小时进行全身和单光子发射计算机断层扫描/计算机断层扫描 (SPECT/CT) 扫描。在 19 名显示骨部位放射性药物摄取增加焦点的患者中，测量了 SUVbwmax。使用 Xeleris 4 软件在 SPECT/CT 横截面图像上确定病理性骨病变和健康组织的 SUVbwmax。
在闪烁成像图像上看到的骨区域中 SSTR 表达增加的总焦点数为 89 个。其中，32 个骨病变在相应的 CT 扫描中可见。这些病变的平均 SUVbwmax 为 31.39（标准差 [SD] 34.31）。对于其他在相应 CT 扫描中不可见的 57 个病变，平均 SUVbwmax 为 19.12（SD 24.24）。在闪烁成像和相应 CT 位置可见的最小骨病变在横截面上测量为 5mm×5mm，位于 Th8 椎体；最大的，测量为 20mm×22mm，位于 L3 椎体。这些病变的 SUVbwmax 分别为 24.70 和 142.40。
[99mTc]Tc-EDDA/HYNIC-TOC 闪烁显像中的 SPECT/CT 可用于定量分析骨病变，即使是很小的病理性骨病变也可以在 [99mTc]Tc-EDDA/HYNIC-TOC 闪烁显像中检测到。结果表明，在 CT 扫描中可见骨病变的情况下，骨肿瘤病变的 SUVbwmax 高于 CT 扫描中不可见病变的 SUVbwmax。体重不会影响骨病变的 SUVbwmax。健康骨组织的 SUVbwmax 随年龄增长而降低。
