(dtpa-phe(1))-octreotide and Skin-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

Lymphoid cells may express somatostatin receptors (SS-Rs) on their cell surface. Therefore radiolabeled somatostatin analogues may be used to visualize SS-R-positive lymphoid neoplasms in vivo. Exact staging is the basis for treatment decisions in cutaneous malignant lymphoma. We considered the possibility that SS-R scintigraphy might offer a clinically useful method of diagnostic imaging in patients with cutaneous malignant lymphoma.. We evaluated SS-R scintigraphy in comparison with conventional staging methods in the staging of cutaneous malignant lymphoma.. We conducted a prospective study in 14 consecutive patients with histologically proven cutaneous malignant lymphoma. SS-R scintigraphy was compared with physical, radiologic, and bone marrow examinations. Lymph node excisions were performed in patients with palpable lymph nodes.. SS-R scintigraphy was positive in the lymph nodes in all four patients with malignant lymph node infiltration and negative in the three patients with dermatopathic lymphadenopathy. In two patients, previously unsuspected lymphoma localizations were visualized by SS-R scintigraphy. In only three patients all skin lesions were visualized by SS-R scintigraphy; these three patients had not been treated with topical corticosteroids. SS-R scintigraphy failed to detect an adrenal mass in one patient and bone marrow infiltration in two patients.. SS-R scintigraphy may help distinguish dermatopathic lymphadenopathy from malignant lymph node infiltration in patients with cutaneous malignant lymphoma.

Topics: Administration, Topical; Adrenal Gland Neoplasms; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Bone Marrow; Female; Follow-Up Studies; Glucocorticoids; Humans; Indium Radioisotopes; Lymph Node Excision; Lymphatic Metastasis; Lymphoma, B-Cell; Lymphoma, T-Cell, Cutaneous; Male; Middle Aged; Neoplasm Staging; Octreotide; Pentetic Acid; Prospective Studies; Receptors, Somatostatin; Skin Neoplasms; Terbium; Tomography, Emission-Computed, Single-Photon

Topics: Female; Humans; Indium Radioisotopes; Middle Aged; Neoplasm Staging; Octreotide; Pentetic Acid; Radionuclide Imaging; Sezary Syndrome; Skin Neoplasms