(dtpa-phe(1))-octreotide and Hodgkin-Disease

Patients with Hodgkin's or non-Hodgkin's lymphoma are staged for treatment based on the extent of known disease involvement and the histopathologic grading of the disease. Radiological techniques, including computed tomography, usually depend on estimates of lymph node enlargement and mass effects as the criterion for disease involvement. Lymphomatous tissue obtained at surgery has shown high-density somatostatin receptors. Several groups have evaluated the utility of 111In-DTPA-pentetreotide (Octreoscan, Mallinckrodt, St. Louis, MO) to detect lymphomatous tissue for more accurate staging of patients with lymphoma. The procedure is safe; both Hodgkin's and non-Hodgkins disease involvement is identified. The results, however, have not been uniformly predictive of disease involvement. Consequently, the routine use of this technique in place of currently used anatomic imaging methods is not recommended at this time. The significance of detecting somatostatin receptors in vivo in patients with malignant lymphoma requires further study.

Topics: Adult; Female; Hodgkin Disease; Humans; Indium Radioisotopes; Lymphoma, Non-Hodgkin; Male; Middle Aged; Octreotide; Pentetic Acid; Predictive Value of Tests; Radionuclide Imaging; Receptors, Somatostatin; Sensitivity and Specificity

This prospective study evaluated somatostatin receptor-specific scintigraphy as a clinical tool for routine detection of malignant lymphoma.. Forty-one consecutive patients were examined using 111In-DTPA-D-Phe-1-octreotide. Thirty-four patients had diagnoses of Hodgkin's disease (n = 11) or non-Hodgkin's lymphoma (n = 23) previously verified and staged by hematology, histology and imaging methods (CT, chest x-ray and abdominal ultrasonography). The remaining seven patients initially suspected of presenting lymphoma (n = 5) or lymphoma recurrence after chemotherapy and radiotherapy (n = 2) were subsequently shown to have other diseases. Planar images were recorded 4, 24 and 48 hr after intravenous injection and evaluated without knowledge of other results. In case of negative planar scintigraphy, additional SPECT images were obtained. Since these failed to increase sensitivity, they were omitted after 15 negative recordings.. Octreotide scintigraphy did not yield false-positive results. The sensitivity for detecting Hodgkin's disease was 70% and varied from 88% in the neck and chest to 13% in the abdomen and pelvis. The sensitivity for non-Hodgkin's lymphoma was not influenced by localization and amounted uniformly to 35% but varied with the degree of malignancy between 44% (high-grade) and 29% (low-grade malignancy).. Our results suggest that radiolabeled octreotide is better suited to characterize somatostatin receptor expressing lymphomas than to localize lesion sites. It is useful for imaging Hodgkin's disease, especially above the diaphragm.

Topics: Adult; Aged; False Positive Reactions; Hodgkin Disease; Humans; Indium Radioisotopes; Lymphoma, Non-Hodgkin; Middle Aged; Octreotide; Pentetic Acid; Prospective Studies; Radionuclide Imaging; Receptors, Somatostatin; Recurrence; Sensitivity and Specificity

Topics: Hodgkin Disease; Humans; Indium Radioisotopes; Lymphoma, Non-Hodgkin; Octreotide; Pentetic Acid; Radionuclide Imaging; Receptors, Somatostatin

Topics: Adult; Breast Neoplasms; Diagnosis, Differential; Female; Hodgkin Disease; Humans; Indium Radioisotopes; Liver Neoplasms; Male; Mediastinal Neoplasms; Middle Aged; Neoplasm, Residual; Octreotide; Pelvic Neoplasms; Pentetic Acid; Radionuclide Imaging; Remission Induction

Somatostatin receptor scintigraphy with 111In-labeled octreotide was performed in 22 patients with suspected or known malignant lymphoma. The majority of extra-abdominal lesions (21/24 = 87.5%) were correctly localized, however, only one of nine intraabdominal lymphomas could be detected. No significant correlation was found between scintigraphic results and histological type of lymphoma. Metabolic imaging by positron-emission tomography with 18F-labeled deoxyglucose yielded a higher rate of detection of lymphoma manifestations (92% vs 64%) and better tumor contrast. Further prospective studies are needed to establish the clinical relevance of somatostatin receptor scintigraphy in malignant lymphoma.

Topics: Adult; Biomarkers, Tumor; Deoxyglucose; Female; Fluorine Radioisotopes; Fluorodeoxyglucose F18; Glucose; Granuloma; Hodgkin Disease; Humans; Hyperplasia; Indium Radioisotopes; Lymph Nodes; Lymphoma; Lymphoma, Non-Hodgkin; Male; Octreotide; Pentetic Acid; Plasmacytoma; Receptors, Somatostatin; Tomography, Emission-Computed