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

The utility of In-111 DTPA octreotide scintigraphy (SRS) for disease detection in patients with metastatic thyroid carcinoma (TCA) remains controversial. The authors compared the sensitivity of In-111-based SRS, F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET), and extensive conventional radiographic imaging (CRI) in this type of cancer.. SRS, FDG PET, and CRI were performed concurrently in 21 patients (age, 56.4 +/- 12.9 years) who had aggressive TCA. Concordance rates % of lesion positivity among pairs of different techniques (A and B) were calculated as the ratio of the number of lesions positive with both techniques divided by the sum of the total number of lesions positive with technique A + total number of lesions positive with technique B, which was then multiplied by 200.. The combined use of CRI, FDG PET, and SRS resulted in the detection of 105 lesions, presumed to be due to metastatic deposits. Sensitivities for SRS and FDG-PET imaging were 49.5% and 67.6%, respectively. The lesion detection concordance rates were as follows: CRI versus FDG PET, 80.8%; CRI versus SRS, 74.2%; and FDG-PET versus SRS, 58.6%. Importantly, SRS detected five unexpected lesions, which were negative by both CRI and FDG-PET imaging. In two representative patients, a positive correlation (Spearman's rank = 0.71; = 0.0576) existed between the percentage of lesional In-111 DTPA octreotide uptake and the standard uptake value in eight concordant lesions.. Although SRS has only moderate sensitivity for disease detection in metastatic TCA, sometimes it can reveal lesions that otherwise would be undetectable by either CRI or FDG-PET imaging.

Topics: Bone Neoplasms; Carcinoma; Cohort Studies; Female; Fluorodeoxyglucose F18; Head and Neck Neoplasms; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Mediastinal Neoplasms; Middle Aged; Octreotide; Pentetic Acid; Pleural Neoplasms; Radiography; Radiopharmaceuticals; Sensitivity and Specificity; Skin Neoplasms; Thyroid Neoplasms; Tomography, Emission-Computed

Twenty-one patients with small cell lung cancer (SCLC) were investigated with 111in-octreotide (111-In-OCT) scintigraphs, 5 hours after the i.v. injection of 111 MBq of the radiotracer. Whole-body and planar scintigraphy as well as SPECT of the thorax were required. The scintigraphic results were compared to those of other conventional diagnostic procedures used for the staging and follow-up of SCLC patients. 111In-OCT detected 86% (48/56) of the lesions already known at the time of scintigraphy, being positive for all 20 SCLC lesions and negative for one lung adenocarcinoma. 111In-OCT showed a high sensitivity for mediastinal metastases (94%) and good sensitivity for bone (75%) and abdominal lymph node metastases (71%). It did not detect 2 liver metastases but revealed 5 unknown lesions which were then confirmed by other diagnostic examinations. 111In-OCT was also effective in patients with low levels of NSE. Three patients received cold octreotide for seven days to investigate whether this treatment might affect SCLC imaging. Scans were performed before and after treatment. The 111In-OCT uptake increased in the cancer lesions while the fixation in normal tissues decreased, demonstrating enhancement of SCLC imaging following cold octreotide administration.

Topics: Adenocarcinoma; Aged; Antineoplastic Agents, Hormonal; Bone Neoplasms; Carcinoma, Small Cell; Diagnostic Imaging; Female; Follow-Up Studies; Humans; Indium Radioisotopes; Injections, Intravenous; Liver Neoplasms; Lung Neoplasms; Lymphatic Metastasis; Male; Mediastinal Neoplasms; Middle Aged; Neoplasm Staging; Octreotide; Pentetic Acid; Phosphopyruvate Hydratase; Radiopharmaceuticals; Sensitivity and Specificity; Tomography, Emission-Computed, Single-Photon

In patients with the Zollinger-Ellison syndrome, which is either sporadic or integrated into multiple endocrine neoplasia type 1, accurate localization of all the tumours is difficult and may have therapeutic implications. In an attempt to improve this localization, somatostatin receptor scintigraphy using [111In-DTPA-D-Phe1]-octreotide was performed prospectively in 48 consecutive patients with the Zollinger-Ellison syndrome. Thirty of them had the sporadic type of this disease. Scintigraphic data were compared with data obtained by conventional imaging methods, and also, in 32 selected patients, with those obtained by endoscopic ultrasonography. Somatostatin receptor scintigraphy showed abnormal tracer uptake in 39 patients (81%), in whom it correctly identified 50 of the 60 tumoral sites (83%) previously localized by the other imaging methods. In 17 patients (35%) somatostatin receptor scintigraphy disclosed abnormal tracer uptake at 18 different tumoral sites: 14 were located in the abdomen, including four in the liver and eight in the duodenopancreatic area, and four outside the abdomen, including two in the mediastinum. Six of the ten tumoral sites which were not correctly identified by somatostatin receptor scintigraphy were located in the duodenopancreatic area. However, in the 20 patients for whom conventional techniques failed to visualize any tumour in the duodenopancreatic area, somatostatin receptor scintigraphy was positive in ten (50%) whereas endoscopic ultrasonography was only positive in five (25%). In our patients with the Zollinger-Ellison syndrome, somatostatin receptor scintigraphy appeared to be a useful new addition to the battery of tests used for tumour detection.

Topics: Bone Neoplasms; Duodenal Neoplasms; Female; Humans; Indium Radioisotopes; Liver Neoplasms; Male; Mediastinal Neoplasms; Middle Aged; Multiple Endocrine Neoplasia Type 1; Octreotide; Pancreatic Neoplasms; Pentetic Acid; Prospective Studies; Radionuclide Imaging; Receptors, Somatostatin; Ultrasonography; Zollinger-Ellison Syndrome

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