Modlin I M, Cornelius E, Lawton G P
Department of Surgery, Yale University School of Medicine, New Haven, Conn, USA.
Arch Surg. 1995 Apr;130(4):367-73; discussion 373-4. doi: 10.1001/archsurg.1995.01430040029003.
To evaluate the effectiveness of indium In 111 pentetate (diethylenetriaminepentaacetic acid [DTPA]-D-Phe-labeled octreotide scintigraphy in the localization of gastroenteropancreatic neuroendocrine lesions, and to identify covert lesions, determine multicentricity, define the distribution of metastases, confirm complete removal of tumor postoperatively, and evaluate the efficacy of therapeutic embolization.
Unmasked comparison.
Tertiary care referral center.
We studied 28 patients over a 12-month period. Biochemical evidence of a gastroenteropancreatic tumor was present in 13 patients. Octreoscan 111 was employed in four patients with an ambiguous biochemical diagnosis of gastroenteropancreatic tumor. Postoperative examination to document complete tumor removal was undertaken in seven patients. In one patient, Octreoscan 111 was used to evaluate the efficacy of therapeutic embolization.
[111In]DTPA-D-Phe-octreotide scintigraphy.
Identification of somatostatin receptor-bearing neuroendocrine tumors.
Intravenous administration of [111In]DTPA-D-Phe-octreotide followed by whole-body gamma camera scintigraphy resulted in the localization of gastroenteropancreatic neuroendocrine tumors with 75% sensitivity, 100% specificity, 100% positive predictive value, 63% negative predictive value, and 82% overall accuracy.
While Octreoscan 111 has been shown to localize the majority of amine precursor uptake and decarboxylation system (APUD) cell tumors as well as various other somatostatin-positive tumors, this technique may also be useful in a number of other circumstances. These include prediction of tumors that will respond to octreotide therapy, identification of covert metastases, intraoperative identification of tumors, and postoperative surveillance. Use of an alternative isotope may provide a vehicle for the administration of local therapeutic radiation to tumor cells. The precise efficacy of Octreoscan 111 in the identification of lesions smaller than 3 cm with low-density somatostatin-2 receptor expression remains to be determined.
评估铟In 111喷替酸盐（二乙烯三胺五乙酸[DTPA]-D-苯丙氨酸标记的奥曲肽闪烁扫描术在胃肠胰神经内分泌病变定位中的有效性，识别隐匿性病变，确定多中心性，明确转移灶分布，确认术后肿瘤是否完全切除，并评估治疗性栓塞的疗效。
非盲法比较。
三级医疗转诊中心。
我们在12个月期间研究了28例患者。13例患者有胃肠胰肿瘤的生化证据。4例胃肠胰肿瘤生化诊断不明确的患者采用了奥曲肽111扫描。7例患者进行了术后检查以记录肿瘤是否完全切除。1例患者使用奥曲肽111评估治疗性栓塞的疗效。
[111In]DTPA-D-苯丙氨酸-奥曲肽闪烁扫描术。
识别含生长抑素受体的神经内分泌肿瘤。
静脉注射[111In]DTPA-D-苯丙氨酸-奥曲肽后进行全身γ相机闪烁扫描，胃肠胰神经内分泌肿瘤定位的灵敏度为75%，特异性为100%，阳性预测值为100%，阴性预测值为63%，总体准确率为82%。
虽然奥曲肽111已被证明可定位大多数胺前体摄取和脱羧系统（APUD）细胞瘤以及其他各种生长抑素阳性肿瘤，但该技术在许多其他情况下也可能有用。这些情况包括预测对奥曲肽治疗有反应的肿瘤、识别隐匿性转移灶、术中识别肿瘤以及术后监测。使用替代同位素可能为向肿瘤细胞给予局部治疗性辐射提供一种手段。奥曲肽111在识别小于3 cm且生长抑素-2受体表达低密度的病变中的精确疗效仍有待确定。
