通过铟-111-二乙三胺五乙酸- D-苯丙氨酸1-奥曲肽闪烁扫描术对恶性胸腺肿块进行体内检测。

In vivo detection of malignant thymic masses by indium-111-DTPA-D-Phe1-octreotide scintigraphy.

作者信息

Lastoria S, Vergara E, Palmieri G, Acampa W, Varrella P, Caracò C, Bianco R A, Muto P, Salvatore M

机构信息

Department of Nuclear Medicine National Cancer Institute, Fondazione G. Pascale, Naples, Italy.

出版信息

J Nucl Med. 1998 Apr;39(4):634-9.

PMID:9544670

Abstract

UNLABELLED

Many tumors with neuroendocrine characteristics express high amounts of somatostatin receptors that enable in vivo imaging with [(111)In-DTPA-D-Phe1]-octreotide. In this study, we have analyzed the feasibility in detecting and characterizing thymic masses by somatostatin receptor scintigraphy (SRS).

METHODS

Eighteen patients (13 women, 5 men, ages 18-78 yr; mean +/- s.d. = 42.1 +/- 17.6 yr) were enrolled in this study. Eleven patients were studied during diagnosis and seven during routine follow-up. In seven patients, myasthenia gravis was the presenting symptom. SRS was performed within 4 wk after CT and/or MRI. Planar and tomographic images were acquired within 24 hr after the injection of approximately 111 MBq of [(111)In-DTPA-D-Phe1]-octreotide. The scintigraphic results were categorized according to the histologic findings.

RESULTS

Histology diagnosed 10 mixed epithelial/lymphoid thymomas (8 with prevalent epithelial component), 2 thymic carcinomas, 1 thymic carcinoid, 1 lymphangioma and 4 thymic hyperplasias. Two thymoma were Stage I, 3 were Stage II, 2 were Stage III and 5 were Stage IV, as was the thymic carcinoid. Indium-111-DTPA-D-Phe1-octreotide concentrated in primary and/or metastatic sites of thymic tumors, thereby enabling successful external gamma imaging of sites greater than 1.5 cm in size. Tumor-to-lung (T/L) ratios were as high as 7.6-fold (range 1.7-7.6). Untreated thymomas showed higher T/L (4.34 +/- 1.57) than treated ones (2.68 +/- 1.18). No uptake was detectable in the four patients with benign thymic hyperplasia and the patient with the lymphangioma.

CONCLUSION

Indium-111-DTPA-D-Phe1-octreotide is avidly concentrated within thymic tumors, but it is not concentrated by thymic hyperplasia, which allows differential diagnosis. Thus, in patients with myasthenia gravis, SRS may have a role in characterizing thymic masses, thereby overcoming the limits of cross-sectional imaging modalities.

摘要

未标记

许多具有神经内分泌特征的肿瘤表达大量生长抑素受体，这使得能够用[（111）铟 - DTPA - D - 苯丙氨酸1] - 奥曲肽进行体内成像。在本研究中，我们分析了通过生长抑素受体闪烁显像（SRS）检测和表征胸腺肿块的可行性。

方法

18例患者（13名女性，5名男性，年龄18 - 78岁；平均±标准差 = 42.1±17.6岁）纳入本研究。11例患者在诊断期间接受研究，7例在常规随访期间接受研究。7例患者以重症肌无力为首发症状。在CT和/或MRI检查后4周内进行SRS。在注射约111 MBq的[（111）铟 - DTPA - D - 苯丙氨酸1] - 奥曲肽后24小时内采集平面和断层图像。根据组织学结果对闪烁显像结果进行分类。

结果

组织学诊断为10例混合性上皮/淋巴细胞性胸腺瘤（8例上皮成分占优势）、2例胸腺癌、1例胸腺类癌、1例淋巴管瘤和4例胸腺增生。2例胸腺瘤为I期，3例为II期，2例为III期，5例为IV期，胸腺类癌也是IV期。铟 - 111 - DTPA - D - 苯丙氨酸1 - 奥曲肽聚集在胸腺肿瘤的原发和/或转移部位，从而能够成功地对直径大于1.5 cm的部位进行体外γ成像。肿瘤与肺（T/L）比值高达7.6倍（范围1.7 - 7.6）。未经治疗的胸腺瘤的T/L（4.34±1.57）高于经治疗的胸腺瘤（2.68±1.18）。4例良性胸腺增生患者和1例淋巴管瘤患者未检测到摄取。