technetium-tc-99m-depreotide and Lung-Neoplasms

To perform a meta-analysis to estimate the diagnostic accuracy of dynamic contrast material-enhanced computed tomography (CT) and magnetic resonance (MR) imaging, fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET), and technetium 99m ((99m)Tc) depreotide single photon emission computed tomography (SPECT) for evaluation of solitary pulmonary nodules (SPNs).. Data sources were studies published in PubMed between January 1990 and December 2005. The selected investigations were comparative and noncomparative diagnostic cohort studies to examine the operating characteristics of the four imaging modalities for evaluation of SPNs, involving at least 10 enrolled participants with histologic confirmation and having sufficient data to calculate contingency tables. A random coefficient binary regression model with disease probability conditioned on test results was used to summarize test performance and construct summary receiver operating characteristic (ROC) curves. Sensitivities, specificities, predictive values, diagnostic odds ratios, and areas under the ROC curve were calculated.. Forty-four studies--10 dynamic CT, six dynamic MR, 22 FDG PET, and seven (99m)Tc-depreotide SPECT--met the inclusion criteria. (One study was included in both the FDG PET and SPECT groups.) Sensitivities, specificities, positive predictive values, negative predictive values, diagnostic odds ratios, and areas under the ROC curve were, respectively, 0.93 (95% confidence interval [CI]: 0.88, 0.97), 0.76 (95% CI: 0.68, 0.97), 0.80 (95% CI: 0.74, 0.86), 0.95 (95% CI: 0.93, 0.98), 39.91 (95% CI: 1.21, 81.04), and 0.93 (95% CI: 0.81, 0.97) for dynamic CT; 0.94 (95% CI: 0.91, 0.97), 0.79 (95% CI: 0.73, 0.86), 0.86 (95% CI: 0.83, 0.89), 0.93 (95% CI: 0.90, 0.96), 60.59 (95% CI: 5.56, 115.62), and 0.94 (95% CI: 0.83, 0.98) for dynamic MR; 0.95 (95% CI: 0.93, 0.98), 0.82 (95% CI: 0.77, 0.88), 0.91 (95% CI: 0.88, 0.93), 0.90 (95% CI: 0.85, 0.94), 97.31 (95% CI: 6.26, 188.37), and 0.94 (95% CI: 0.83, 0.98) for FDG PET; and 0.95 (95% CI: 0.93, 0.97), 0.82 (95% CI: 0.78, 0.85), 0.90 (95% CI: 0.83, 0.97), 0.91 (95% CI: 0.84, 0.98), 84.50 (95% CI: 34.28, 134.73), and 0.94 (95% CI: 0.83, 0.98) for (99m)Tc-depreotide SPECT.. Dynamic CT and MR, FDG PET, and (99m)Tc-depreotide SPECT are noninvasive and accurate in distinguishing malignant from benign SPNs; differences among these tests are nonsignificant.

Topics: Contrast Media; Diagnostic Imaging; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Magnetic Resonance Imaging; Organotechnetium Compounds; Predictive Value of Tests; Radiopharmaceuticals; Regression Analysis; ROC Curve; Sensitivity and Specificity; Solitary Pulmonary Nodule; Somatostatin; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

The somatostatin analogue octreotide was the first radiopeptide to be used for the scintigraphic diagnosis of tumors. Somatostatin receptor scintigraphy (SRS) has proven its value, especially in the detection of gut neuroendocrine tumors. In some tumor types, it is considered the diagnostic gold standard. In carcinoid tumors of the lung, SRS is of major importance in diagnostic workup. Furthermore, the combination of computed tomography scanning and SRS is a reliable and cost-effective approach for the evaluation of single pulmonary nodules. Despite these favorable properties, SRS fails in the detection of metastases of lung cancer. The problem of false-positive results in SRS resulting from inflammatory disease might be overcome by the use of new radiopeptides such as cholecystokinin-B receptor-binding gastrin analogues. This article focuses on the current status of peptide-receptor scintigraphy in the diagnosis of lung tumors and on future developments in this field.

Topics: Cost-Benefit Analysis; Diagnosis, Differential; Gastrointestinal Agents; Humans; Lung Neoplasms; Neoplasm Metastasis; Neuroendocrine Tumors; Octreotide; Organotechnetium Compounds; Peptides, Cyclic; Prognosis; Radionuclide Imaging; Somatostatin; Tomography, X-Ray Computed

Several tumors overexpress somatostatin receptors (SSTR) and can thus be imaged with radiolabeled analogues of somatostatin. Tc-99m depreotide is a new radiolabeled somatostatin analogue that shows high affinity for SSTR2, SSTR3, and SSTR5 subtypes. It has been recently FDA-approved for use in the evaluation of indeterminate solitary pulmonary nodules. SPECT with Tc-99m depreotide is highly accurate in this clinical setting and may be preferable to FDG-PET because of its lower cost and wider availability. Large studies are also underway to evaluate the accuracy of Tc-99m depreotide in staging of lung cancer.

Topics: Carcinoma, Non-Small-Cell Lung; Fluorodeoxyglucose F18; Humans; Lung; Lung Neoplasms; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Receptors, Somatostatin; Solitary Pulmonary Nodule; Somatostatin

The use of gallium for pulmonary diseases is hampered by its relative lack of specificity, typical 1- to 3-day delay between injection and imaging time, and suboptimal imaging characteristics. Other nuclear and nonnuclear imaging modalities, such as (18)F-fluorodeoxyglucose positron emission tomography (PET) and high-resolution chest computed tomography, have replaced gallium in many clinical algorithms. Yet gallium and other radiotracers, such as thallium, sestamibi, and labeled white blood cells, are useful in many specific clinical situations involving lymphoma and other neoplasias, inflammatory processes such as sarcoid and interstitial pneumonia, tuberculosis and other infections, and the acquired immune deficiency syndrome. Gallium and some of the other single-photon agents still have value in establishing a diagnosis, assessing the location and extent of disease, differentiating active disease from chronic scarring, guiding potential biopsy, and determining recurrence and response to therapy in patients with certain lung diseases, particularly when access to PET imaging is not available.

Topics: 3-Iodobenzylguanidine; AIDS-Related Opportunistic Infections; Citrates; Gallium; Gallium Radioisotopes; Humans; Indium Radioisotopes; Intercellular Signaling Peptides and Proteins; Iodine Radioisotopes; Leukocytes; Lung Diseases; Lung Neoplasms; Peptides; Radionuclide Imaging; Radiopharmaceuticals; Receptors, Somatostatin; Somatostatin; Technetium Tc 99m Sestamibi; Thallium Radioisotopes; Tuberculosis, Pulmonary

Tomographic imaging with either F-18 fluoro deoxyglucose (FDG) (a nonmetabolizable glucose analog that reflects tumor increased glucose metabolism) or technetium Tc-99m Depreotide (a synthetic peptide that binds with high affinity to cell surface receptors with increased expression on certain tumor cells) provides improved sensitivity and specificity in the differential diagnosis of solitary pulmonary nodules (SPN) compared with noninvasive and some invasive procedures. F-18 FDG requires instrumentation capable of coincident imaging whereas Tc-99m Depreotide can be imaged on standard gamma cameras equipped to perform single photon emission computed tomography (SPECT) imaging. Either technique performs better than CT alone, and both are cost effective on the basis of reducing unnecessary biopsies and thoracotomies in patients with negative studies indicating that the SPN is nonmalignant.

Topics: Aged; Contrast Media; Diagnosis, Differential; Fluorodeoxyglucose F18; Humans; Intercellular Signaling Peptides and Proteins; Lung Neoplasms; Male; Middle Aged; Peptides; Radiopharmaceuticals; Receptors, Somatostatin; Sensitivity and Specificity; Solitary Pulmonary Nodule; Technetium; Tomography, Emission-Computed; Tomography, Emission-Computed, Single-Photon

In Sweden, there are over 3000 new lung cancer cases every year. There are still numerous patients with undetermined lesions after routine diagnostic evaluation by clinical examination, chest radiography, computed tomography (CT) of the thorax, and bronchoscopy. An appropriate method for further diagnostic workup is therefore needed.. To evaluate the diagnostic value of the somatostatin analogue depreotide in patients with suspected lung cancer, and to determine in which clinical settings it would be beneficial to use 99mTc-depreotide scintigraphy.. We included 99 consecutive patients referred to our hospital with suspected lung cancer. A clinical examination, bronchoscopy, chest radiography, CT of the thorax and upper abdomen, and scintigraphy were done. Scintigraphy was performed after injection of 740 MBq (99m)Tc depreotide with tomographical imaging of the thorax and whole-body scanning. The diagnostic outcome of the scintigrams was compared to CT, using morphology or clinical outcome as the endpoint.. 99mTc-depreotide uptake was found in 62 out of 66 malignancies, including 57 of 58 primary lung cancer cases. Two cases of lung metastasis (one from a colon cancer and one from an adenoid cystic carcinoma originating in the palate) and one rib chondrosarcoma did not show depreotide uptake. There were 33 patients with benign lesions, of whom 16 displayed false-positive 99mTc-depreotide uptake, whereof 11 were pneumonias. Tc-99m-depreotide uptake was absent in 17 patients with benign lesions, including all 10 hamartomas. The sensitivity in detecting malignancy was 94%, and in detecting lung cancer 98%. The specificity was calculated based on two sets of data. When all cases were used, the specificity was 52%. If the 12 pneumonias are excluded, the specificity was 77%.. 99mTc-depreotide scintigraphy has a high sensitivity in detecting lung cancer. The method is useful in decision-making with respect to surgery.

Topics: Adult; Aged; Aged, 80 and over; Diagnosis, Differential; False Negative Reactions; False Positive Reactions; Female; Hamartoma; Humans; Image Enhancement; Lung; Lung Neoplasms; Male; Middle Aged; Observer Variation; Organotechnetium Compounds; Pneumonia; Predictive Value of Tests; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Somatostatin; Tomography, X-Ray Computed

To evaluate the diagnostic accuracy of 99m Tc-depreotide vs PET-18FDG scans in patients with suspicion of lung cancer.. Prospective study in 29 patients (age: 38-80 years) diagnosed of inderteminate lung lesions. Diagnosis was established by histology based on samples of surgical resection, fine needle aspiration (FNA) or broncoalveolar lavage (BAL). Within a maximum of 10 days, without pre-established fixed order the following exams were performed: 1) Whole body and chest SPECT-CT with Tc-depreótide (DEP-SPECT) and 2) PET-CT study with F-FDG (PET-FDG). Every exam was evaluated by Nuclear Medicine especialist blinded to patient data.. Malignancy was confirmed in 20 patients. PET-FDG was positive in all cases. DEP-SPECT was positive in 17 and falselly negative in 3, one carcinoid tumor, one undifferentiated non-small cell adenocarcinoma, and a moderately differentiated adenocarcinoma. In the remaining 9 patients benignancy was confirmed; both studies were normal in 8 and falselly positive in one case of non-specific inflammatory lung process. In 9 out of the 20 cases with malignancy extrapulmonar uptake was seen, with a total number of 19 lesions. In two cases the extrapulmonar uptake were non ganglionar metastasis (bone and adrenal) and in 7 due to mediastinic ganglionar involvement. ROC analysis using peak SUV FDG (cut-off point of 3.5) uptake and target/background depreotide uptake (cut-off point of 1.3) provided, sensitivity and specificity values of 95% and 89% of 84% and 88% for PET and SPECT respectively. It does not exist statistically significant differences between both methods (Z-test SPSS). In summary, FDG-PET has a greater sensitivity and diagnostic accuracy for assessing malignancy of indeterminate lung lesions, and for detection of extrapulmonary involvement, DEP-SPECT represents a good diagnostic alternative for centers where PET is not available.

Topics: Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Diagnostic Errors; Female; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Positron-Emission Tomography; Prospective Studies; Radiography; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Somatostatin; Tomography, Emission-Computed, Single-Photon

The aim of this study was to evaluate the clinical usefulness of scintigraphy with 99mTc-depreotide in the assessment of loco-regional nodal spread in patients with suspected lung cancer in comparison with computed tomography (CT).. Eighty-six patients were investigated with single-photon emission computed tomography (SPECT) of the thorax after i.v. injection of 740 MBq 99mTc-depreotide. The results were evaluated in conjunction with a thoracic CT scan in all 86 patients with 204 lymph node stations. The scintigraphic results were correlated with cytological (38), histological (20) or clinical-radiological (146) findings and compared with CT. The quantitative evaluation of depreotide uptake was performed on 48 cytologically or histologically verified nodal stations from 28 patients by SPECT using region of interest analysis with four different reference regions.. 99mTc-depreotide scintigraphy for all 204 investigated lymph node stations had a sensitivity of 99% and a negative predictive value of 98% in determining lymph node involvement. Scintigraphy and CT showed the same level of accuracy, 76.4%. CT findings had a higher positive predictive value but a lower negative predictive value compared to 99mTc-depreotide scintigraphy. The quantitative evaluation of depreotide uptake in lymph nodes using vertebra as a reference region showed that a cut-off level of 0.56 excludes malignant involvement of lymph nodes, while a cut-off level of 1.66 excludes benign disease in lymph nodes. About 73% of all investigated lymph node stations showed uptake values between these cut-off levels.. Absence of 99mTc-depreotide uptake on scintigraphic imaging can exclude regional lymph node involvement with a high degree of probability and may be useful in clinical practice. The quantitative evaluation of depreotide uptake in regional lymph nodes did not increase the diagnostic accuracy of the method in general but did elucidate the lymph node status in some patients.

Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Lung Neoplasms; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Organotechnetium Compounds; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Somatostatin

The purpose of the study was to compare ( 18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and ( 99m)Tc-depreotide single-photon emission computed tomography (SPECT) in the diagnosis of malignancy of solitary pulmonary nodules (SPNs).. Twenty-eight patients without any history of cancer and presenting an SPN (0.8-3 cm in size) underwent FDG PET and depreotide SPECT. Depreotide SPECT and FDG PET were performed on a double-head gamma camera and a dedicated PET scanner respectively. Twenty-five out of 28 lesions were removed by thoracotomy or assessed by biopsy (n=1) and histologically examined. A strategy of serial CT scanning was adopted in the three remaining patients.. Histological findings revealed 18 malignant nodules and seven benign lesions. Stability over a 2-year period indicated a benign process in the remaining three cases. Both techniques yielded true positive results in 15 of the 18 cancers. FDG PET identified two additional adenocarcinomas not detected by depreotide SPECT. A carcinoid tumour not visualised on FDG PET was identified by depreotide SPECT. Seven of the ten benign lesions did not reveal tracer uptake on either depreotide SPECT or FDG PET. Both techniques showed false positive results for the same two lesions. One more false positive was seen on FDG PET. FDG PET and depreotide SPECT had a sensitivity of 94.4% and 88.9% respectively; this difference was not significant. In our experience, depreotide SPECT and FDG PET are equally sensitive (92.3%) for large (>1.5 cm) and equally specific (85.7%) for small (up to 1.5 cm) SPNs suspicious for malignancy.. This study showed( 18)F-FDG PET to be more sensitive than ( 99m)Tc-depreotide SPECT in the diagnosis of malignancy of SPNs. However, the combination of both techniques may provide additional accuracy.

Topics: Adult; Aged; Female; Fluorodeoxyglucose F18; France; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Pilot Projects; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Severity of Illness Index; Solitary Pulmonary Nodule; Somatostatin; Tomography, Emission-Computed, Single-Photon

Indeterminate lung nodules (LN) constitute a clinical problem of increasing frequency that requires an effective diagnostic approach. This study evaluates the contribution of 99mTc-depreotide scintigraphy in the management of such patients. Forty (40) patients (27 males/13 females) 29 to 82 years old (61 +/- 12) with lung nodules/masses of indeterminate origin on computed tomography (CT) images were injected with 99mTc-depreotide and underwent thoracic tomography (single photon emission computed tomography) 2 and 4-4.5 hours later. All parenchymal lesions (50) identified by CT were scored as negative or positive as to the uptake of 99mTc-depreotide. Positive images were also evaluated semiquantitatively. Thirty (30) of 31 malignant lesions were positive (97% sensitivity) and 12 out of 19 benign lesions were negative (63% specificity), with positive images obtained in benign processes such as inflammation/infection and bronchiectasis. Semiquantitative analysis showed a statistically significant difference between benign and malignant positive lesions on the late images, and may play a complementary role in interpretation. 99mTc-depreotide was a useful noninvasive tool in the evaluation of patients with LN, allowing for the exclusion of malignancy with great confidence, due to its high sensitivity. Because of moderate specificity, a positive test is best valued together with clinical and radiological features.

Topics: Adult; Aged; Female; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Radiopharmaceuticals; Sensitivity and Specificity; Somatostatin; Tomography, Emission-Computed, Single-Photon

Scintigraphy with 99mTc-depreotide, a somatostatin analogue-technetium ligand, has been used for evaluation of various malignant neoplasms, including lung cancer. The diagnosis of bone metastases in patients with lung cancer is not always definitive with current imaging methods. Visualisation of somatostatin receptors (SSTRs) in bone lesions, when the primary tumour exhibits such receptors, could be helpful in characterising them as metastatic. The aim of this study was to assess the value of 99mTc-depreotide in differentiating between benign and malignant bone lesions in patients with lung cancer.. The study population comprised 20 patients (17 males and three females, mean age 63 years) with proven lung cancer in whom bone lesions had been detected by conventional imaging methods. All patients underwent 99mTc-hydroxydiethylene diphosphonate and 99mTc-depreotide scintigraphy within 2 weeks. Bone lesions were classified as benign or malignant on the basis of clinical, imaging and/or histological criteria.. 99mTc-depreotide uptake in the primary tumour was seen in 19 of the 20 patients. Conventional imaging methods detected 55 bone lesions, 31 of which were classified as malignant. Twenty-eight (90%) of these lesions showed 99mTc-depreotide uptake, suggesting bone metastases, while three did not. Twenty-four bone lesions were classified as benign by conventional imaging methods, and none of them showed 99mTc-depreotide uptake. In addition, 99mTc-depreotide demonstrated extra-osseous lesions in six patients.. In patients with lung cancer and bone lesions, 99mTc-depreotide scintigraphy uptake in the bone lesions supports the diagnosis of malignancy, in particular if the primary lung tumour also exhibits SSTRs. Furthermore, whole-body 99mTc-depreotide scintigraphy may disclose extra-osseous disease.

Topics: Adult; Aged; Aged, 80 and over; Bone Neoplasms; Carcinoma; Female; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Somatostatin

To evaluate the diagnostic value of a new somatostatin analog, 99mTc-Depreotide, in differentiating benign from malignant lesions in patients with pulmonary nodules or masses.. A pilot study was performed on 28 patients referred to our Lung Department on suspicion of lung cancer. A chest X-ray, computed tomography (CT) of the thorax and upper abdomen, and scintigraphy were done--scintigraphy following the administration of 740 MBq 99mTc-Depreotide. Planar and tomographical imaging of the thorax and whole-body scanning with a gamma camera were done, and diagnostic outcome of the scintigrams was compared to CT, pathology, and clinical outcome.. Of 21 patients who had a focal high uptake of Depreotide, 17 were malignancies. One patient had two lesions with high Depreotide uptake, lung cancer, and pneumonia in the contralateral lung. Two patients with sarcoidosis and one with bilateral round atelectasis also had high Depreotide uptake bilaterally. Seven of the 8 patients with no uptake were true negative: 5 hamartomas and 2 round atelectases. One small lung cancer in the pleura sinus did not have Depreotide uptake.. The somatostatin analog Depreotide is promising for discriminating between malignant and benign lung lesions.

Topics: Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Female; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Pilot Projects; Radionuclide Imaging; Receptors, Somatostatin; Somatostatin

To investigate the potential role of Tc-99m depreotide (Tc-DEPR) in the preoperative lymph node (N) staging of non-small-cell lung cancer (NSCLC).. Sixty-one patients with NSCLC at the potentially operable stage were enrolled and underwent scintigraphy before surgery (n=56) or mediastinoscopy (n=5). Imaging was performed with a hybrid single photon emission computed tomography/computed tomography (SPECT/CT) system. Depreotide uptake in N stations was evaluated visually and semi-quantitatively and compared to histology. Quantification was carried out in attenuation-corrected SPECT slices. Different sites of normal uptake were used as a reference for comparison with lesional uptake. Receiver operating characteristic analysis was employed to identify the most preferable reference area and the cut-off best discriminating disease-free from disease-involved lymph nodes.. With reference to 53 Ν1 hilar and 147 Ν2/Ν3 sampled stations, sensitivity of scintigraphy by visual interpretation was 100 and 94%, specificity 43 and 59% and accuracy 55 and 67%, respectively. No patient was down-staged, but 52% were incorrectly up-staged and 44% were misclassified as inoperable. Compared to scintigraphy, preoperative contrast-enhanced diagnostic CT demonstrated lower sensitivity (36% for hilar and 73% for N2/N3 stations), higher specificity (79 and 75%) and similar accuracy (70 and 75%). Regarding the ultimate N-stage and the prediction of surgical disease, diagnostic CT was wrong in 51 and 34% of cases. Dichotomy of quantitative scintigraphic data by the use of certain N-to-spine ratio cut-offs resulted in a significant increase of specificity (76% for hilar and 89% for N2/N3 stations), while sensitivity remained high (82% in both circumstances) and accuracy for Ν2/Ν3 stations was substantially improved (88%). By this quantitative approach, misclassifications as to the N-stage and patient operability (25 and 16%) were considerably less than that of visual Tc-DEPR and diagnostic CT interpretations.. Tc-99m depreotide SPECT/CT seems to have a role in the N-staging of NSCLC, mainly because of its high sensitivity and negative predictive value. Quantification of uptake can improve specificity, at a low cost of sensitivity. If F-18 fluoro-deoxyglucose positron emission tomography is not available, this method may be used as a surrogate to conventional staging modalities.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Non-Small-Cell Lung; Female; Humans; Image Processing, Computer-Assisted; Lung Neoplasms; Lymph Nodes; Male; Middle Aged; Multimodal Imaging; Neoplasm Staging; Organotechnetium Compounds; Preoperative Period; Somatostatin; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

The aim of our study was to assess diagnostic accuracy of Tc-99m depreotide and Tc-99m-EDDA/HYNIC-TOC scintigraphy for evaluation of pulmonary lesions that appeared ambiguous on computed tomography (CT).. Forty-nine consecutive patients (37 men and 12 women; mean age, 60 ± 11 years) with 60 pulmonary lesions on chest radiography and CT were referred for nuclear imaging. They were prospectively allocated to undergo whole-body scintigraphy (WBS) and single photon emission computed tomography (SPECT) using either Tc-99m depreotide (26 patients, group 1) or Tc-99m-EDDA/HYNIC-TOC imaging (23 patients, group 2). Histologic findings after tissue biopsy served as a gold standard for determining diagnostic accuracy of the 2 somatostatin analogs. Visual assessment was complemented by semiquantitative analysis based on target to background ratio.. Among the 32 pulmonary lesions scanned with Tc-99m depreotide, focal uptake was increased in 22 of 25 malignancies, whereas no uptake was found in 6 of 7 benign lesions (88% sensitivity, 85% specificity, and 88% accuracy) on both WBS and SPECT. Imaging of 28 pulmonary lesions with Tc-99m-EDDA/HYNIC-TOC had a similar diagnostic yield (sensitivity 87%, specificity 84%, and accuracy 86%). Overall, target to background ratios were higher on SPECT than WBS but not significantly different between groups 1 and 2 (SPECT 2.72 ± 0.70 vs. 2.71 ± 0.50, WBS 1.61 ± 0.32 vs. 1.62 ± 0.28, respectively).. This study demonstrates that Tc-99m depreotide and Tc-99m-EDDA/HYNIC-TOC have similar diagnostic value for characterizing pulmonary lesions that appear ambiguous on CT.

Topics: Female; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Somatostatin

A contrast-enhanced multidetector CT (MDCT) scan is the first choice examination when evaluating patients with suspected lung cancer. However, while the clinical focus is on CT, research focus is on molecular biological methods whereby radiolabelled pharmaceuticals are injected into participants and target malignant lung tumours. We examined whether a contrast-enhanced MDCT scan supplied with an additional non-contrast enhanced high-resolution CT scan, or a newer but more expensive (99m)Tc depreotide single photon emission CT (SPECT) scan, was the better first-choice examination for the work-up of pulmonary lesions. Furthermore, we examined whether a (99m)Tc depreotide SPECT scan was an appropriate second-choice examination for patients with indeterminate lesions.. 140 participants were included in the analysis. CT images were given a malignancy potential rating of 1, 2 or 3 with higher rating being indicative of disease. (99m)Tc depreotide SPECT images were graded either positive or negative. Histopathology and CT follow-up were used as reference standard. Sensitivity, specificity and diagnostic accuracy were calculated.. Overall sensitivity, specificity and diagnostic accuracy of CT were 97%, 30% and 84%, respectively. Overall sensitivity, specificity and diagnostic accuracy of (99m)Tc depreotide SPECT were 94%, 58% and 76%, respectively. For indeterminate lesions sensitivity, specificity and diagnostic accuracy of (99m)Tc depreotide SPECT were 71%, 68% and 69%, respectively.. Both CT and (99m)Tc depreotide SPECT made valuable contributions to the evaluation of pulmonary lesions. (99m)Tc depreotide SPECT results were not superior to CT results and did not contribute further to the diagnostic work-up. Regarding indeterminate lesions,( 99m)Tc depreotide SPECT sensitivity was too low.

Topics: Adult; Aged; Aged, 80 and over; Cohort Studies; Confidence Intervals; Contrast Media; Diagnosis, Differential; Female; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Multidetector Computed Tomography; Organotechnetium Compounds; Prospective Studies; ROC Curve; Sensitivity and Specificity; Solitary Pulmonary Nodule; Somatostatin; Tomography, Emission-Computed, Single-Photon

The (99m)Tc-labeled agent, ((99m)TcO)depreotide, has received regulatory approval in the United States and Europe for use in the detection of cancer. It is essential to establish a simple and reliable method of direct radiolabeling of (99m)Tc-depreotide and to investigate its specific receptor binding properties with human non small cell lung cancer (NSCLC) A549 cell in vitro. So we made some researches as follow: Depreotide was labeled with (99m)Tc using SnCl2 as a reductant. Labeling efficiencies at different pH values and temperatures were compared. Radioreceptor assay was used to observe the uptake kinetics, stagnation and retention half time of (99m)Tc-depreotide in A549 cells. As the results of the investigation ,many facts is shown below: The labeling rate of pH 6.0 group was higher than that of pH 5.0 and pH7.0 groups. The labeling rate decreased when temperature increased from 15 °C to 50 °C. The uptake rate increased with rising temperature, and the maximum uptake was observed at 60 min at 37 °C. The cleaning curves were similar at different temperatures, and the half cleaning time at 37 °C was 48 min. The results showed that the optimal conditions for labeling depreotide with (99m)Tc was found to be below 15 °C at a pH lower than 6.0. Furthermore, at 37 °C, (99m)Tc-depreotid may have the potential as an ideal imaging agent for somatostatin receptors.

Topics: Carcinoma, Non-Small-Cell Lung; Cell Line, Tumor; Chromatography, High Pressure Liquid; Drug Stability; Humans; Hydrogen-Ion Concentration; Lung Neoplasms; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Receptors, Somatostatin; Somatostatin; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Temperature

Somatostatin receptor (SSTR) scintigraphy with (99m)Tc-depreotide is used for differential diagnosis of solitary pulmonary nodules. The method is based on SSTR expression in cancer tissue.. To estimate the expression of SSTRs in non-small-cell lung cancer (NSCLC) in vitro, and to determine the correlation between (99m)Tc-depreotide uptake in vivo and different tumor characteristics determined in vitro, such as tumor grade, and presence of SSTR2, MIB-1, and p53.. A total of 127 patients with lung lesions detected on computed tomography (CT) were investigated with SSTR scintigraphy after injection of 740 MBq (99m)Tc-depreotide. This study includes 19 patients with NSCLC with histologically proven diagnosis. The quantitative evaluation of (99m)Tc-depreotide was performed using region-of-interest analysis and includes tumor counts/cm(3), background counts/cm(3), and the ratio between tumor and background counts.. 99mTc-depreotide uptake was found in all NSCLC tumors, which expressed SSTR2 defined in vitro by immunochemical methods. SSTR2 expression was negatively correlated to the degree of the tumor's differentiation (P<0.05). 99mTc-depreotide uptake in tumor cells did not correlate with tumor grade, or SSTR2, MIB-1, or p53 expression.. There is an expression of SSTRs in NSCLC. The degree of tumor differentiation correlates negatively with SSTR2 measured in vitro and positively with MIB-1 expression in tumor tissue. No correlation was found between (99m)Tc-depreotide uptake and possible prognostic factors such as MIB-1 and p53 expression in tumor cells in NSCLC. Lastly, no correlation was found between (99m)Tc-depreotide uptake and tumor grade or SSTR2 expression.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Non-Small-Cell Lung; Diagnosis, Differential; Female; Humans; Immunoenzyme Techniques; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Receptors, Somatostatin; Somatostatin

At present also radionuclide methods are used to diagnose pulmonary malignancies. One of them is solitary pulmonary nodule (SPN) scintigraphy using 99mTc-depreotide. 99mTc-depreotide is a somatostatin analogue with affinity to 3 out of 5 subtypes of somatostatin receptors.. was to confirmed the usefulness of 99mTc-depreotide in detecting malignancy in SPN; finding lymph nodes metastases; and overlapping scintigraphic scans and CT in precise localizsation of malignancy and its lymph nodes metastases.. The group studied comprised 50 patients with radiologically diagnosed SPN. Forty patients had a high resolution CT scan done with a GE Light Speed equipment-device. The acquired CT scans were sent via LAN (Local Area Network) to an ARPACS server in the Department of Nuclear Medicine, and thence to a Hermes Nuclear Diagnostics workstation. CT examinations were followed by scintigraphy with 99mTc-depreotide.. In 32 patients 99mTc-depreotide was found to have accumulated excessively in SPN: in 23 cases malignancy was found, in the 9 remaining cases they were other abnormalities. In the 23 lung cancer patients, 99mTc-depreotide was found in 24 foci, including 18 in the mediastinum and axillary region. CT revealed affected lymph nodes only in 7 cases. The calculated sensitivity, specificity and accuracy in SPN were 89%, 60%, 82%, respectively. The tumour/background index in malignancies confirmed histologically was 2.58 +/- 0.89. Where lymph nodes metastases were suspected in the diagnosed malignancies, the lymph node/background index was 2.60 +/- 0.85. In 25 cases lesion localization was more accurate when scans were overlapped.. 99mTc-depreotide based examination is a sensitive method in the evaluation of SPN malignancy. Overlapping SPECT and CT scans in diagnosing SPN enables both pathological and physiological changes to be localized precisely. This method seems particularly valuable in imaging lymph nodes where metastases are suspected, especially when CT scans revealed no abnormalities.

Topics: Carcinoma, Bronchogenic; Humans; Lung; Lung Neoplasms; Lymphatic Metastasis; Organotechnetium Compounds; Sensitivity and Specificity; Solitary Pulmonary Nodule; Somatostatin; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

To compare (99m)Tc-depreotide and (201)Tl chloride SPET in the characterization of pulmonary lesions.. Fifty-seven pulmonary lesions from 33 patients suspected of malignancy in computed tomography, were assessed by (99m)Tc-depreotide and (201)Tl early and delayed SPET imaging. Images were visually assessed and the tumour-to-normal (T/N) lung activity ratio for early (ER) and delayed (DR) scans and the retention index (RI), were calculated in every lesion. A final diagnosis was reached for all lesions, based either on histology or prolonged clinical and radiological follow-up.. Twenty-three lesions were characterized as malignant and 34 benign. In visual analysis, all malignant lesions accumulated both tracers resulting in sensitivity and negative predictive values of 100%. However, false positive interpretations resulted in a specificity of 64.7% and 67.6% for (99m)Tc-depreotide and (201)Tl, respectively. ER and DR of both agents and the RI of (99m)Tc-depreotide were significantly higher in malignant, compared to benign lesions. In defining thresholds of abnormality from ROC analysis, a significant increase in specificity was observed for both tracers in both scan phases (91.2% for all), as compared to visual analysis (P<0.01). There was no significant difference in the diagnostic performance between (99m)Tc-depreotide DR and (201)Tl DR, although the former provided the highest T/N ratio.. This study demonstrates that (99m)Tc-depreotide and (201)Tl SPET are equally effective and may be useful in the non-invasive determination of lung malignancy. The specificity of both techniques is significantly improved by quantifying radiopharmaceutical accumulation in pulmonary lesions.

Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Positron-Emission Tomography; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Solitary Pulmonary Nodule; Somatostatin; Thallium; Tomography, Emission-Computed, Single-Photon

The diagnosis of malignancy may be difficult to establish in solitary pulmonary nodules (SPNs).. It was the aim of this study to assess diagnostic performances of technetium-99m ((99m)Tc)-depreotide in differentiating benign from malignant SPNs and compare its diagnostic accuracy with fluor-18-fluoro-deoxyglucose positron emission tomography (FDG-PET) in a subgroup of patients.. One hundred and eighteen patients presenting with an SPN < or =3 cm suspected of malignancy on CT were included in a prospective, open-label, European multicentre trial. Single photon emission computed tomography (SPECT) images were acquired 1.1-4.5 h after injection of 459-770 MBq of (99m)Tc-depreotide. A subset of 29 patients also underwent FDG-PET imaging. Images were interpreted blindly and correlated with histopathology.. (99m)Tc-depreotide was positive in 65 of 73 patients with a malignant lesion and negative in 30 of 45 patients with a benign lesion, resulting in a sensitivity, specificity and diagnostic accuracy of 89, 67 and 81%, respectively. In 40 patients with SPN < or =1.5 cm, diagnostic accuracy was 88, sensitivity 75 and specificity 96%. In the subset of 29 patients who underwent both (99m)Tc-depreotide SPECT and FDG-PET imaging, sensitivity, specificity and diagnostic accuracy were identical for both modalities, i.e. 90, 67 and 83%, respectively.. The diagnostic accuracy of (99m)Tc-depreotide SPECT is good and comparable with FDG-PET imaging in SPN of indeterminate origin.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Positron-Emission Tomography; Prospective Studies; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Solitary Pulmonary Nodule; Somatostatin

Topics: Algorithms; Humans; Lung Neoplasms; Organotechnetium Compounds; Solitary Pulmonary Nodule; Somatostatin; Tomography, Emission-Computed, Single-Photon

Topics: Adult; Aged; Aged, 80 and over; False Negative Reactions; Female; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Receptors, Somatostatin; Sensitivity and Specificity; Somatostatin; Tomography, X-Ray Computed

Topics: Bone Neoplasms; Humans; Lung Neoplasms; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Solitary Pulmonary Nodule; Somatostatin; Technetium Tc 99m Medronate; Whole-Body Counting

(177)Lu-DOTA-Tyr(3)-octreotate is a candidate radiopharmaceutical for the therapy of somatostatin receptor (sstr)-positive small cell lung cancer (SCLC). Scintigraphy of lung tumors is made with 2 alternative somatostatin analogs, (111)In-DTPA-octreotide or (99m)Tc-depreotide. The aim of this study was to compare the biodistribution of these 3 radiopharmaceuticals in SCLC xenografted to nude mice.. Nude mice, bearing tumors from the human SCLC cell line NCI-H69, were intravenously injected with 10 MBq (2.4 microg) (99m)Tc-depreotide and 2 MBq (0.5 microg) (111)In-DTPA-octreotide simultaneously. The activity concentration (%IA/g) was measured in tumor and normal tissue at 2, 4, and 24 hours postinjection (hpi). The results were compared with earlier published biodistribution data of 3 MBq (0.7 microg) (177)Lu-DOTA-Tyr(3)-octreotate in the same animal model.. The activity concentration of (111)In-DTPAoctreotide in tumor was higher than the activity concentration of (99m)Tc-depreotide at 2-24 hpi, p < 0.05. The highest tumor uptake at 24 hpi was, however, found for (177)Lu-DOTA-Tyr(3)-octreotate. The activity concentration of (99m)Tc-depreotide was significantly higher in the heart, lungs, liver, the salivary glands, spleen, and bone marrow than for (111)In-DTPA-octreotide at 2-24 hpi. Saturation of the somatostatin receptors may have influenced the uptake in tumor and sstr-positive normal tissues.. The low tumor-to-lung and tumor-to-liver activity concentration ratios for (99m)Tc-depreotide could result in a lower detection rate of SCLC with this compound versus (111)In-DTPA-octreotide. (177)Lu-DOTA-Tyr(3)-octreotate gave the highest tumor-activity concentration, and has, thus, the best properties for therapy.

Topics: Animals; Carcinoma, Small Cell; Cell Line, Tumor; Disease Models, Animal; Humans; Indium Radioisotopes; Liver; Lung; Lung Neoplasms; Mice; Mice, Nude; Neoplasm Transplantation; Neoplasms, Experimental; Octreotide; Organometallic Compounds; Organotechnetium Compounds; Pentetic Acid; Radiopharmaceuticals; Somatostatin; Time Factors; Tissue Distribution

99mTc-Depreotide has been used on single pulmonary nodules to identify somatostatin receptor-positive lung cancer. We report that pulmonary metastases of a 78-y-old man with postradical nephrectomy for renal cell carcinoma were detected by (99m)Tc-depreotide chest SPECT. Thus, (99m)Tc-depreotide chest SPECT can be used to diagnose secondary lung cancer, such as pulmonary metastases from renal cell carcinoma with somatostatin receptor-positive tumor, other than primary lung cancer. Depending on whether the (99m)Tc-depreotide was positive for pulmonary metastases, the patient underwent an appropriate therapy without further invasive procedures.

Topics: Aged; Carcinoma, Renal Cell; Humans; Kidney Neoplasms; Lung Neoplasms; Male; Organotechnetium Compounds; Radiopharmaceuticals; Somatostatin; Tomography, Emission-Computed, Single-Photon

Lung carcinoma is one of the most common neoplasms, both in men and women. Many methods are employed within diagnostics approaches in oncology, among them are radiological, endoscopic, cytological and isotopic ones. Synthetic proteins labelled with gallium (Ga67), indium (In111) or technetium (Tc99) binding with receptors localised on cells surface enable scintigraphic determination of intensive uptake sites. The aim of the study was to asses clinical usefulness of technetium99 labelled synthetic somatostatin analogue (depreotide) in the diagnosis of solitary pulmonary nodules. Thirty one patients (19 men and 12 women) with isolated peripheral pulmonary lesions in chest X-ray examination were included into the study. All patients received intravenous infusion of synthetic protein compound, trifluorodepreotide acetate labelled with technetium99, with radio activity of 555-740 MBq (mega Becquerel) [Neospect--Nycomed Amersham, UK]. Radiopharmaceutical uptake was determined by two-head gamma camera according SPECT method (single photon emission computed tomography) after 3-4 hours after an injection. Intensive radiopharmaceutical uptake by abnormal lesions was found in 22 patients (71%), however in 9 (29%) it was not found in the sites of radiological changes. Among 22 patients with intensive uptake, in 17 (77%) patients a diagnosis of carcinoma was confirmed and in 5 patients benign lesions were diagnosed. In the group of 5 patients without marker uptake single case of carcinoma was found and in 4 benign lesions. Four patients refused further invasive diagnostic procedures. The sensitivity of this method was 94% with a specificity of 44%. No serious adverse clinical reactions associated with 99Tc depreotide were observed.. 1. Technetium99 labelled synthetic somatostatin analogue [(depreotide) (NeoSpect)] is safe in pulmonological and oncological clinical diagnostics. 2. The use of this compound is a valuable scintigraphic, supplementary method to qualify patients for further invasive diagnosis of peripheral pulmonary solitary nodules.

Topics: Aged; Female; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Radiopharmaceuticals; Sensitivity and Specificity; Solitary Pulmonary Nodule; Somatostatin; Time Factors; Tomography, Emission-Computed, Single-Photon

The authors report two cases of round atelectasis that showed increased accumulation of technetium (Tc) 99m depreotide on planar and single photon emission computed tomographic scintigraphy. It should be considered that round atelectasis is a potential nonmalignant cause for positive 99mTc depreotide scintigraphy.

Topics: Aged; Diagnosis, Differential; False Positive Reactions; Humans; Intercellular Signaling Peptides and Proteins; Lung Neoplasms; Male; Peptides; Pulmonary Atelectasis; Respiratory Function Tests; Sensitivity and Specificity; Solitary Pulmonary Nodule; Tomography, Emission-Computed, Single-Photon

Topics: Bone Marrow; Carcinoma, Bronchogenic; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasms, Squamous Cell; Organotechnetium Compounds; Pneumonectomy; Radiation Injuries; Radionuclide Imaging; Radiopharmaceuticals; Somatostatin; Spine; Sternum

The affinity of various malignant neoplasms including small cell and non-small cell lung cancer for peptide analogue of somatostatin has been documented. Depreotide is such an analogue and can be combined with technetium--99m (99mTc depreotide) for optical imaging properties. Using this radiopharmaceutical product, solitary pulmonary nodules (SPN) were previously successful evaluated. In this article the preliminary study of the depreotide (NeoSpect--Amersham, Wielka Brytania) in clinical practice has been shown.

Topics: Aged; Female; Humans; Lung Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Organotechnetium Compounds; Radiopharmaceuticals; Solitary Pulmonary Nodule; Somatostatin; Technetium

Tc-99m depreotide (NeoSpect) is a radiolabeled somatostatin analog introduced recently for scintigraphic imaging of patients with lung cancer. Eighteen patients were examined 2 to 4 hours after administration of 740 MBq mCi Tc-99m depreotide. In 13 patients (72.2%) bilateral symmetric activity corresponding to the large, deep apocrine sweat glands of the axillae was present. This observation is clinically relevant regardless of its reason or mechanism. It is important to be aware of this reason for activity in the axillae when assessing lymph node involvement not only in patients with lung cancer but also in breast cancer patients using scintigraphy with Tc-99m depreotide.

Topics: Axilla; Breast Neoplasms; Female; Humans; Lung Neoplasms; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Somatostatin; Sweat Glands

Topics: Biopsy, Needle; Carcinoma, Bronchogenic; Carcinoma, Squamous Cell; False Negative Reactions; Humans; Lung Neoplasms; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Radiography; Radiopharmaceuticals; Somatostatin; Thallium; Tomography, Emission-Computed, Single-Photon

Topics: Carcinoma, Small Cell; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Organotechnetium Compounds; Radiopharmaceuticals; Receptors, Somatostatin; Somatostatin; Tomography, Emission-Computed

Topics: Aged; Aged, 80 and over; Biopsy; Carcinoma, Small Cell; Cell Transformation, Neoplastic; Diagnosis, Differential; False Positive Reactions; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Organotechnetium Compounds; Radiopharmaceuticals; Somatostatin; Tomography, X-Ray Computed

A 63-year-old woman with previously treated stage I lung cancer was reexamined 5 years later for recurrence. A conventional work-up using computed tomographic scanning and transbronchial biopsy showed nothing abnormal. A Tc-99m depreotide scan, however, led to a noninvasive diagnosis of lung cancer recurrence with metastases, and it directed a noninvasive tissue diagnosis.

Topics: Adenocarcinoma; Bone Neoplasms; Female; Humans; Leg; Lung Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Scapula; Soft Tissue Neoplasms; Somatostatin; Technetium Tc 99m Medronate; Thoracic Vertebrae; Whole-Body Counting

A 76-year-old man with chronic obstructive pulmonary disease and a smoking history had a 2-cm solitary pulmonary nodule that was likely to be malignant. He underwent Tc-99m-labeled somatostatin receptor-binding peptide SPECT. A computed tomographic-guided transthoracic needle biopsy performed before the SPECT was nondiagnostic. SPECT showed increased uptake of the tracer by the nodule, which was subsequently found to be adenocarcinoma by surgical resection. Differentiation of malignant from benign nodules by Tc-99m-labeled somatostatin imaging may be a reasonable approach in patients at high risk for cancer and concurrently at increased risk for complications from invasive diagnostic procedures or surgical resection.

Topics: Adenocarcinoma; Aged; Fatal Outcome; Heart; Humans; Lung Neoplasms; Male; Organotechnetium Compounds; Radiopharmaceuticals; Solitary Pulmonary Nodule; Somatostatin; Tomography, Emission-Computed, Single-Photon

Topics: Contrast Media; Humans; Image Enhancement; Intercellular Signaling Peptides and Proteins; Lung; Lung Neoplasms; Peptides; Sensitivity and Specificity; Solitary Pulmonary Nodule; Somatostatin; Tomography, Emission-Computed, Single-Photon

The affinity of various malignant neoplasms including small cell and non-small cell lung cancer for peptide analogs of somatostatin has been well documented. Depreotide is such an analog and can be complexed with technetium-99m ((99m)Tc depreotide) for optimal imaging properties. Using this radiopharmaceutical, solitary pulmonary nodules (SPN) were previously evaluated in a successful phase II/III trial. The results of the larger multicenter phase III study using (99m)Tc depreotide to differentiate malignant and benign etiologies in SPN are now presented.. Patients with SPN 30 years, and no demonstrable radiographic stability for the prior 2 years were studied. All underwent single-photon emission CT (SPECT) with (99m)Tc depreotide and subsequent tissue histologic examination. Three nuclear medicine specialists blinded to histologic findings examined the SPECT images and scored them as positive or negative based on the presence or absence of activity in the radiographic region of the SPN. The final result was determined by the majority score, which was then compared with the histologic result.. Of the 114 individuals studied, 88 had a histologic result compatible with malignant neoplasm. (99m)Tc depreotide scintigraphy correctly identified 85 of this group, with three false-negative determinations compared with histology. There were seven false-positive determinations, including six granulomas and one hamartoma. (99m)Tc depreotide scintigraphy correctly excluded malignancy in 19 of 26 patients with benign histologic findings. The sensitivity of this method was 96.6% with a specificity of 73.1%.. (99m)Tc depreotide scintigraphy is a safe and useful method for the noninvasive evaluation of SPN with a sensitivity and accuracy comparable to that reported for fluorine-18 fluorodeoxyglucose positron emission tomography.

Topics: Aged; Carcinoma, Non-Small-Cell Lung; Carcinoma, Small Cell; Contrast Media; Diagnosis, Differential; Female; Humans; Image Enhancement; Intercellular Signaling Peptides and Proteins; Lung; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Peptides; Predictive Value of Tests; Prospective Studies; Solitary Pulmonary Nodule; Somatostatin; Tomography, Emission-Computed, Single-Photon

Topics: Biomarkers, Tumor; Contrast Media; Diagnosis, Differential; Humans; Intercellular Signaling Peptides and Proteins; Lung Diseases; Lung Neoplasms; Peptides; Reagent Kits, Diagnostic; Receptors, Somatostatin; Tomography, Emission-Computed; Tomography, X-Ray Computed