(dtpa-phe(1))-octreotide and Abdominal-Neoplasms

In the present study we have investigated the three-dimensional (3D) reconstruction of OctreoScan111 SPECT (single photon emission tomography) images in 20 patients with neuroendocrine tumours. All patients had at least 2 tumour lesions as assessed from computerized tomography (CT) and SPECT. The 3D rendering was performed using a software, which produces images by implementing direct rendering from voxels without an intermediate surface data structure. The software has options for a free choice of thresholding and possibilities of clipping in coronal, transversal and sagittal planes. The results obtained showed that 3D reconstruction with volume rendering (3Dvr) gave a superior topographical localization of tumour uptakes when compared with SPECT. The 3Dvr technique was also combined with transversal clipping in rendered volumes (3Dvr+c). The major advantage with the 3Dvr+c technique was found to be an improved visualization of anatomical references as well as improved diagnostic information in a particular, selected, transversal slice, thus facilitating the identification and comparison of individual tumour lesions.

Topics: Abdominal Neoplasms; Carcinoid Tumor; Female; Humans; Image Processing, Computer-Assisted; Indium Radioisotopes; Intestinal Neoplasms; Male; Neoplasms; Neurosecretory Systems; Octreotide; Pentetic Acid; Tomography, Emission-Computed, Single-Photon

Topics: Abdominal Neoplasms; Aged; Aged, 80 and over; Bird Fancier's Lung; Carcinoma, Hepatocellular; Chronic Disease; Diagnosis, Differential; Heart; Humans; Incidental Findings; Liver Neoplasms; Lung; Male; Myocarditis; Octreotide; Pentetic Acid; Radionuclide Imaging; Radiopharmaceuticals

This study presents the first successful use of a peptidic vector, DOTATOC, labelled with the beta-emitting radioisotope yttrium-90, for the treatment of a patient with somatostatin receptor-positive abdominal metastases of a neuroendocrine carcinoma of unknown localization. Tumour response and symptomatic relief were achieved. In addition, the new substance DOTATOC was labelled with the diagnostic chemical analogue indium-111 and studied in three patients with histopathologically verified neuroendocrine abdominal tumours for its diagnostic sensitivity and compared with the commercially available OctreoScan. In all patients the kidney-to-tumour uptake ratio (in counts per pixel) was on average 1. 9-fold lower with 111In-DOTATOC than with OctreoScan. DOTATOC could be a potential new diagnostic and therapeutic agent in the management of neuroendocrine tumours.

Topics: Abdominal Neoplasms; Adult; Humans; Indium Radioisotopes; Male; Middle Aged; Neuroendocrine Tumors; Octreotide; Pentetic Acid; Radionuclide Imaging; Radiopharmaceuticals; Receptors, Somatostatin; Sensitivity and Specificity; Yttrium Radioisotopes

Superimposition of SPECT and computed tomography (CT) slices from the thoracoabdominal region was achieved without the use of external markers for 14 studies in 13 patients with endocrine carcinoma. Technical feasibility and clinical validation of this retrospective fusion method were assessed.. Patients had a history of thyroid cancer or of carcinoid tumor. To detect tumor sites, CT scan and dual-isotope tomoscintigraphy were performed, with 99mTc-hydroxymethylene diphosphonate for bone scintigraphy and with 111In-pentetreotide, 131I or 131I-metaiodobenzylguanidine for tumor scintigraphy (TS). A superimposition method previously developed for the pelvic region was adapted to the nonrigid thoraco-abdominal region. CT-bone scintigraphy and CT-TS superimposed images were obtained. Clinical validation of the information obtained from the superimposed images was obtained from surgery or follow-up imaging studies performed after clinical evolution of the disease process.. Reliable and reproducible registration was achieved in all patients. CT-TS superimposed images produced accurate localization of abnormal TS foci. Accuracy was limited primarily by variable relative displacements of the thoracoabdominal organs. For 10 sites in 8 patients, localization and/or characterization obtained from CT-TS images was confirmed by a reference technique. Superimposition enabled the localization of tumor sites that otherwise could not have been suspected from CT alone and allowed the characterization of CT suspicious masses and the confirmation of CT positive sites. Nonspecific tumor TS uptake sites were also localized.. With standard CT and dual-isotope SPECT acquisitions, SPECT-CT fusion is feasible in the thoracoabdominal region without the use of external markers. Fused images were validated in 8 patients for 10 sites. The use of this technique could probably improve the management and care of patients with endocrine carcinoma.

Topics: 3-Iodobenzylguanidine; Abdominal Neoplasms; Carcinoid Tumor; Carcinoma, Medullary; Feasibility Studies; Humans; Image Processing, Computer-Assisted; Indium Radioisotopes; Iodine Radioisotopes; Iodobenzenes; Octreotide; Pentetic Acid; Radiopharmaceuticals; Reproducibility of Results; Retrospective Studies; Technetium Tc 99m Medronate; Thoracic Neoplasms; Thyroid Neoplasms; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Indium-111 activity concentrations in human tumor and normal tissue samples were determined at 24, 48 and 120 hr after i.v. injection of 111In-DTPA-D-Phe-1-octreotide. Fourteen patients were included in the study. Seven patients had medullary thyroid carcinoma, four had midgut carcinoid tumors, two had endocrine pancreatic tumors and one had chronic pancreatitis.. For midgut carcinoids, the tumor-to-blood ratio was 51:220, for medullary thyroid carcinoma 4:39, and for two endocrine pancreatic tumors 6 and 1500. Tumor-to-muscle ratios varied between 1 and 1200 and tumor-to-fat between 2 and 1500 depending on tumor type.. The sometimes extremely high tumor-to-normal tissue ratios present the possibility for use of radiolabeled octreotide for radiation therapy of somatostatin receptor positive tumors.

Topics: Abdominal Neoplasms; Adult; Aged; Carcinoid Tumor; Chronic Disease; Female; Humans; Indium Radioisotopes; Injections, Intravenous; Male; Middle Aged; Neuroendocrine Tumors; Octreotide; Pancreatic Neoplasms; Pancreatitis; Pentetic Acid; Radionuclide Imaging; Receptors, Somatostatin; Reference Values; Thyroid Neoplasms