Chiti A, Fanti S, Savelli G, Romeo A, Bellanova B, Rodari M, van Graafeiland B J, Monetti N, Bombardieri E
Istituto Nazionale per lo Studio e la Cura dei Tumori, Division of Nuclear Medicine, Milan, Italy.
Eur J Nucl Med. 1998 Oct;25(10):1396-403. doi: 10.1007/s002590050314.
Neuroendocrine tumours displaying somatostatin receptors have been successfully visualised with somatostatin receptor imaging (SRI). However, there may be differences in sensitivity depending on the site of the primary tumour and/or its metastases. We studied 131 patients affected by neuroendocrine tumours of the gastro-entero-pancreatic (GEP) tract. A pathological diagnosis was obtained in 116 patients, while in 15 the diagnosis was based on instrumental results and follow-up. Fifty-one patients were examined for staging purposes, 80 were in follow-up. Images were acquired 24 and 48 h after the injection of 150-220 MBq of indium-111 pentetreotide. Whole-body and SPET images were obtained in all patients. Patients were also studied with computed tomography (CT), ultrasound (US), and other procedures. Tumours were classified according to their site of origin: pancreas n = 39, ileum n = 32, stomach n = 16, appendix n = 9, duodenum n = 5, jejunum n = 5, rectum n = 3, biliary tract n = 2, colon n = 2, caecum n = 1, liver metastases from unknown primary = 15, widespread metastases from unknown primary = 2. Sensitivity for primary tumour localisation was as follows: SRI = 62%; CT = 43%; US = 36%; other procedures = 45%. Sensitivity for liver metastases: SRI = 90%; CT = 78%; US = 88%; other procedures = 71%. Sensitivity for the detection of extrahepatic soft tissue lesions was: SRI = 90%; CT = 66%; US = 47%; other procedures = 61%. Sensitivity for the detection of the primary tumour in patients with metastases from unknown primary sites: SRI 4/17; CT 0/13; US 0/12; other procedures 1/10. In 28% of the patients SRI revealed previously unknown lesions, and in 21% it determined a modification of the scheduled therapy. Our study confirms the important role of SRI in the management of GEP tumours. However, we feel that a critical investigation should address its role in locating primary tumours, in particular in patients with metastases from unknown primary sites.
利用生长抑素受体成像（SRI）已成功实现对显示生长抑素受体的神经内分泌肿瘤的可视化。然而，根据原发性肿瘤及其转移灶的部位不同，敏感性可能存在差异。我们研究了131例胃肠胰（GEP）道神经内分泌肿瘤患者。116例患者获得了病理诊断，15例患者的诊断基于影像学检查结果及随访情况。51例患者用于分期检查，80例患者处于随访中。在注射150 - 220 MBq的铟-111喷曲肽后24小时和48小时采集图像。所有患者均进行了全身及单光子发射计算机断层扫描（SPET）成像。患者还接受了计算机断层扫描（CT）、超声（US）及其他检查。肿瘤根据其起源部位分类：胰腺n = 39，回肠n = 32，胃n = 16，阑尾n = 9，十二指肠n = 5，空肠n = 5，直肠n = 3，胆道n = 2，结肠n = 2，盲肠n = 1，原发灶不明的肝转移瘤 = 15，原发灶不明的广泛转移瘤 = 2。原发性肿瘤定位的敏感性如下：SRI = 62%；CT = 43%；US = 36%；其他检查 = 45%。肝转移瘤的敏感性：SRI = 90%；CT = 78%；US = 88%；其他检查 = 71%。检测肝外软组织病变的敏感性为：SRI = 90%；CT = 66%；US = 47%；其他检查 = 61%。对原发灶不明的转移瘤患者检测原发性肿瘤的敏感性：SRI 4/17；CT 0/13；US 0/12；其他检查1/10。在28%的患者中，SRI发现了先前未知的病变，在21%的患者中，SRI决定了预定治疗方案的改变。我们的研究证实了SRI在GEP肿瘤管理中的重要作用。然而，我们认为应进行一项关键研究，以探讨其在定位原发性肿瘤中的作用，特别是在原发灶不明的转移瘤患者中。
