1
|
Detection of Bone Metastases by 68Ga-DOTA-SSAs and 18F-FDG PET/CT: A Two-Center Head-to-Head Study of Gastroenteropancreatic Neuroendocrine Neoplasms. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:1750132. [PMID: 36447752 PMCID: PMC9663244 DOI: 10.1155/2022/1750132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/08/2022] [Indexed: 11/10/2022]
Abstract
Purpose This study aimed to assess the efficacy of dual-tracer [68Ga-DOTA-somatostatin receptor analogs (SSAs) and 18F-fluorodeoxyglucose (FDG)] positron emission tomography/computed tomography (PET/CT) imaging for detecting bone metastases (BMs) in patients with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). Methods We retrospectively enrolled 74 GEP-NEN patients with BMs from two centers, who underwent dual-tracer PET/CT from January 2014 to March 2021. We compared and analyzed effectiveness of the dual PET/CT imaging techniques on the BMs, based on 18F-FDG and 68Ga-DOTA-SSAs. Specifically, we analyzed the imaging results using χ 2 tests for classification variables, paired-sample tests for number of BMs, Wilcoxon's signed rank test for number of lesions, and the Kruskal-Wallis test for standard uptake value (SUV) ratio comparison. The correlation of dual-tracer SUVmax with Ki-67 index was analyzed by Spearman's correlation coefficient. Results The detection efficiencies of dual-tracer PET/CT imaging in patients with different pathologies showed discordant for detecting liver metastases and BMs in group neuroendocrine tumor (NET) G3, 68Ga-DOTA-SSAs was better at detecting BMs for NET G3 (P=0.049 for SUVT/B and P=0.026 for the number of metastatic lesions). In addition, statistical significance was found among osteogenesis group, osteolysis group, and the no-change group (for bone SUVT/B value detected by 18F-FDG and Ki-67 index, osteogenesis group < osteolysis group; for bone SUVT/B detected by 68Ga-DOTA-SSAs, osteogenesis group > the no-change group). What is more, liver and bone SUVmax and Ki-67 index were positively correlated in 18F-FDG imaging (P < 0.001 for liver; P=0.002 for bone), and negatively correlated in 68Ga-DOTA-SSAs imaging (P < 0.001 for liver; P=0.039 for bone). Conclusions 68Ga-DOTA-SSAs was superior to 18F-FDG for detecting BMs in NET G1/G2 (well and moderately differentiated NETs), as well as in NET G3 (poorly differentiated NETs). Relatively good differentiation was observed in the osteogenesis group. In addition, dual-tracer PET/CT imaging results were observably correlated with tumor differentiation.
Collapse
|
2
|
Guilbaud T, Berbis P, Birnbaum DJ. Glucagonoma with Paraneoplasic Dermatitis: Diagnosis and Management. J Gastrointest Surg 2020; 24:701-703. [PMID: 31152349 DOI: 10.1007/s11605-019-04267-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 05/10/2019] [Indexed: 01/31/2023]
Affiliation(s)
- Théophile Guilbaud
- Department of Digestive surgery, Hôpital Nord, Université Aix-Marseille, France, Hôpital Nord, Chemin des Bourrely 13915, cedex 20, Marseille, France.
| | - Philippe Berbis
- Department of Dermatology, Hôpital Nord, Université Aix-Marseille, France, Hôpital Nord, Chemin des Bourrely 13915, cedex 20, Marseille, France
| | - David Jérémie Birnbaum
- Department of Digestive surgery, Hôpital Nord, Université Aix-Marseille, France, Hôpital Nord, Chemin des Bourrely 13915, cedex 20, Marseille, France
| |
Collapse
|
3
|
Corrias G, Horvat N, Monti S, Basturk O, Lin O, Saba L, Bodei L, Reidy DL, Mannelli L. Malignant transformation of glucagonoma with SPECT/CT In-111 OctreoScan features: A case report. Medicine (Baltimore) 2017; 96:e9252. [PMID: 29390362 PMCID: PMC5815774 DOI: 10.1097/md.0000000000009252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/25/2017] [Accepted: 11/21/2017] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Glucagonoma is an uncommon disease but it has been associated with a pattern of symptoms defined as glucagonoma syndrome. These symptoms, if promptly recognized, could help to speed up the diagnosing process. PATIENT CONCERNS We report a case of a 68-year-old woman with a pancreatic glucagonoma. Her symptoms at the onset were typical of the glucagonoma syndrome. DIAGNOSES After a significant weight loss, she underwent a computer tomography scan of the abdomen, which showed a hypervascular lesion of the tail of the pancreas and hypervascular lesions of the liver. An ultrasound guided biopsy was performed and pathology was consistent with glucagonoma. Her blood glucagon levels were elevated. OUTCOMES She was treated with chemotherapy and somatostatin analogs. After 4 years, the disease had a malignant transformation, and metastases suddenly started to grow up. She stopped being responsive to treatment and eventually passed away. LESSONS Due to its rarity, clinical diagnosis is challenging and generally it comes after a long interval since the onset of symptoms. Awareness of physicians and dermatologists of the characteristic necrolytic migratory erythema, and of the other symptoms, often leads to early diagnosis.
Collapse
Affiliation(s)
- Giuseppe Corrias
- Department of Radiology, Memorial Sloan Kettering Cancer Center, NY
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | - Natally Horvat
- Department of Radiology, Memorial Sloan Kettering Cancer Center, NY
- Department of Radiology, Hospital Sírio-Libanês, São Paulo
- Department of Radiology, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | | | | | - Luca Saba
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | - Lisa Bodei
- Department of Radiology, Memorial Sloan Kettering Cancer Center, NY
| | - Diane L. Reidy
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Lorenzo Mannelli
- Department of Radiology, Memorial Sloan Kettering Cancer Center, NY
| |
Collapse
|
4
|
Ruf J, von Wedel F, Furth C, Denecke T, Stelter L, Steffen IG, Schütte K, Arend J, Ulrich G, Klose S, Bornschein J, Apostolova I, Amthauer H. Significance of a Single-Time-Point Somatostatin Receptor SPECT/Multiphase CT Protocol in the Diagnostic Work-up of Gastroenteropancreatic Neuroendocrine Neoplasms. J Nucl Med 2015; 57:180-5. [PMID: 26609177 DOI: 10.2967/jnumed.115.161117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 11/11/2015] [Indexed: 02/04/2023] Open
Abstract
UNLABELLED This prospective study compared a 1-d SPECT/CT protocol with the commonly used 3-d protocol for somatostatin receptor scintigraphy in patients with gastroenteropancreatic neuroendocrine neoplasms. Additionally, the influence of SPECT/CT on patient management was evaluated. METHODS From October 2011 to October 2012, all gastroenteropancreatic neuroendocrine neoplasm patients undergoing restaging with somatostatin receptor scintigraphy on a modern SPECT/CT device were enrolled in this study. The protocol consisted of planar imaging at 4, 24, and 48 h; low-dose SPECT/CT at 24 and 48 h; diagnostic CT at 24 h using a triple-phase delay after administration of contrast; and diagnostic SPECT/CT at 24 h. All components of the imaging data were reassessed by 3 masked interpreters. The results were compared with a reference standard based on all clinical, imaging, and histopathology follow-up data available (follow-up range, 24-36 mo; mean, 29.9 mo). The reference standard was defined by a study-specific interdisciplinary tumor board that also reassessed treatment decisions. RESULTS Thirty-one patients were eligible for analysis (18 men and 13 women; mean age, 60.4 y). Ten had no imaging signs of disease and remained disease-free during follow-up. Twenty-one had persistent or recurrent disease (82 lesions: 24 in the liver, 21 in the lymph nodes, 16 in bone, 12 in the pancreas, and 9 in other locations). The respective lesion detection rates for interpreters 1, 2, and 3 were 51.9%, 49.4%, and 71.6% for low-dose SPECT/CT at 24 h; 51.9%, 55.6%, and 67.9% for low-dose SPECT/CT at 48 h; 63.0%, 70.4%, and 85.2% for diagnostic CT; and 77.8%, 84.0%, and 88.9% for diagnostic SPECT/CT. Interobserver agreement was moderate for diagnostic SPECT/CT (κ = 0.44), diagnostic CT (κ = 0.43), low-dose SPECT/CT at 48 h (κ = 0.61), and low-dose SPECT/CT at 24 h (κ = 0.55). For planar imaging, interobserver agreement was fair after 48 h (κ = 0.36) and 24 h (κ = 0.38) and moderate after 4 h (κ = 0.42). Every lesion detectable on planar imaging or low-dose SPECT/CT was also detectable on diagnostic SPECT/CT. The CT and SPECT components of diagnostic SPECT/CT strongly complemented each other, as 34 of 82 lesions (41.4%) were detected on only the CT component or only the SPECT component. Therapeutic management was influenced by the diagnostic SPECT/CT interpretation in 8 of 31 patients (25.8%). CONCLUSION The highest detection rates were achieved by diagnostic SPECT/CT. Thus, a more patient-friendly 1-d protocol is feasible. Furthermore, multiphase SPECT/CT affected management in about a quarter of patients.
Collapse
Affiliation(s)
- Juri Ruf
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany Klinik für Nuklearmedizin, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Friederike von Wedel
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| | - Christian Furth
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| | - Timm Denecke
- Klinik für Strahlenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Lars Stelter
- Klinik für Strahlenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ingo G Steffen
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| | - Kerstin Schütte
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| | - Jörg Arend
- Klinik für Allgemein-, Viszeral-, und Gefäßchirurgie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany; and
| | - Gerhard Ulrich
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| | - Silke Klose
- Klinik für Nieren- und Hochdruckkrankheiten, Diabetologie, und Endokrinologie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| | - Jan Bornschein
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| | - Ivalya Apostolova
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| | - Holger Amthauer
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| |
Collapse
|
5
|
Contribution of ¹¹¹In-pentetreotide SPECT/CT imaging to conventional somatostatin receptor scintigraphy in the detection of neuroendocrine tumours. Nucl Med Commun 2015; 36:251-9. [PMID: 25369750 DOI: 10.1097/mnm.0000000000000239] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AIM The aim of the study was to assess the contribution of 111In-pentetreotide single-photon emission computed tomography/computed tomography (SPECT/CT) imaging to conventional somatostatin receptor scintigraphy (SRS) in terms of lesion characterization and localization in the detection of neuroendocrine tumours (NETs). MATERIALS AND METHODS A total of 107 patients with suspected or confirmed NET underwent SRS and SPECT/CT after the injection of 148-222 MBq of 111In-pentetreotide. SRS and SPECT/CT images were interpreted independently. Each site of abnormal tracer uptake was recorded according to the anatomical localization, and as being consistent or not with NET. The findings were confirmed with pathological and/or clinical/imaging follow-up data. RESULTS A final diagnosis of NET was achieved in 49/107 patients (45.8%). No evidence of NET was found in the rest. SPECT/CT resulted in a significant reduction of indeterminate cases [14/107 (13.1%) vs. 1/107 (0.9%); P<0.001] and correctly reclassified one patient as negative for NET and another as positive for NET. SPECT/CT had 87.8% sensitivity and 96.6% specificity on a patient-based analysis, statistically higher than SRS (P<0.001). A total of 160 foci were detected (108 NETs and 52 physiological/benign tumours). SRS correctly classified 105/160 foci (65.6%) and remained inaccurate for 55 lesions. These 55 included 31 indeterminate lesions, 12 lesions detected only by SPECT/CT and 12 false-positive lesions. The number of foci correctly classified on the SPECT/CT images was 151/160 (94.4%), whereas two remained indeterminate and seven were false-positive findings. CONCLUSION SPECT/CT provides incremental diagnostic value over SRS, mainly because of a precise anatomical localization that helps discriminate between tumour lesions and physiological uptake. SPECT/CT may detect unsuspected lesions in a small proportion of patients.
Collapse
|