Tenenbaum F, Lumbroso J, Schlumberger M, Mure A, Plouin P F, Caillou B, Parmentier C
Service de Médecine Nucléaire, Institut Gustave-Roussy, Villejuif, France.
J Nucl Med. 1995 Jan;36(1):1-6.
The results of in vivo somatostatin scintigraphy were correlated with those of MIBG from 14 patients, aged 22-66 yr, with metastatic pheochromocytoma (10 patients), malignant paraganglioma (3 patients) and metastatic ganglioneuroblastoma (1 patient). Twelve patients had elevated catecholamine excretion. A dynamic study and serial whole-body scans (4-48 hr) were obtained after injection of 130-187 MBq of 111In-DTPA-Phe-1-octreotide. When indicated, SPECT imaging was done. The results were compared to MIBG scans obtained after a diagnostic or a therapeutic dose.
Three patients with more than 20 tumor sites on MIBG scans had only 1-9 sites on 111In-octreotide scintigraphy. Two patients had no MIBG uptake but one had lung uptake on octreotide scintigraphy. In the other 9 patients with a total of 41 foci of MIBG uptake, 33 sites of 111In-octreotide uptake are found. All positive images with octreotide scintigraphy were seen at or before 4 hr, but the contrast improved at 24 hr. Uptake intensity was lower with 111In-octreotide than MIBG and the number of tumor sites was higher with MIBG. However, seven foci were positive only on octreotide scintigraphy and six of them could not be confirmed by other imaging modalities.
Use of octreotide to identify somatostatin receptors seems promising, especially when results from MIBG scans are negative. Moreover octreotide images could aid in determining a treatment regimen as well as establishing the extent of disease and prognosis.
对14例年龄在22至66岁之间的患者进行了体内生长抑素闪烁扫描结果与间碘苄胍（MIBG）扫描结果的相关性分析，这些患者患有转移性嗜铬细胞瘤（10例）、恶性副神经节瘤（3例）和转移性神经母细胞瘤（1例）。12例患者儿茶酚胺排泄量升高。注射130 - 187MBq的111铟 - DTPA - 苯丙氨酸 - 1 - 奥曲肽后进行动态研究和系列全身扫描（4 - 48小时）。必要时进行单光子发射计算机断层扫描（SPECT）成像。将结果与诊断剂量或治疗剂量后获得的MIBG扫描结果进行比较。
MIBG扫描显示有20个以上肿瘤部位的3例患者，111铟 - 奥曲肽闪烁扫描仅显示1 - 9个部位。2例患者MIBG无摄取，但1例患者奥曲肽闪烁扫描显示肺部有摄取。在另外9例共有41个MIBG摄取灶的患者中，发现了33个111铟 - 奥曲肽摄取部位。奥曲肽闪烁扫描的所有阳性图像在4小时或之前出现，但在24小时时对比度有所改善。111铟 - 奥曲肽的摄取强度低于MIBG，MIBG显示的肿瘤部位数量更多。然而，7个病灶仅在奥曲肽闪烁扫描时呈阳性，其中6个无法通过其他成像方式得到证实。
使用奥曲肽识别生长抑素受体似乎很有前景，尤其是当MIBG扫描结果为阴性时。此外，奥曲肽图像有助于确定治疗方案以及确定疾病范围和预后。
