Impact of 111In-DTPA-octreotide SPECT/CT fusion images in the management of neuroendocrine tumours

Istituto di Medicina Nucleare, Dipartimento di Bioimmagini e Scienze Radiologiche, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168 Roma, Italy.
La radiologia medica (Impact Factor: 1.37). 10/2008; 113(7):1056-67. DOI: 10.1007/s11547-008-0319-9
Source: PubMed

ABSTRACT Somatostatin receptor scintigraphy with [(111)In]-diethylene triamine pentaacetate acid (DTPA)-octreotide is an accurate method for detecting neuroendocrine tumours (NETs) but often does not provide clear anatomical localisation of lesions. The aim of this study was to assess the clinical usefulness of anatomical-functional image fusion.
Fifty-four patients with known or suspected NET were included in the study. Planar and single-photon-emission computed tomography (SPECT) imaging was performed using a dual-head gamma camera equipped with an integrated X-ray transmission system, and the images were first interpreted alone by two nuclear medicine physicians and then compared with SPECT/CT fusion images together with a radiologist. The improvement provided by SPECT/CT in the interpretation of SPECT data alone and any modification in patient management were recorded.
Fusion images improved SPECT interpretation in 23 cases, providing precise anatomical localisation of increased tracer uptake in 20 cases and disease exclusion in sites of physiological uptake in 5. In 10 patients, SPECT/CT allowed definition of the functional significance of lesions detected by diagnostic CT. SPECT/CT data modified clinical management in 14 cases by changing the diagnostic approach in 8 and the therapeutic modality in 6.
Our study demonstrates that image fusion is clearly superior to SPECT alone, allowing precise localisation of lesions and reducing false-positive results.

Download full-text


Available from: Giorgio Treglia, Jul 17, 2015
1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: Neuroendokrine Tumore des gastroenteropankreatischen Systems (GEP-NET) stellen eine sehr heterogene Gruppe mit steigender Inzidenz und Prävalenz dar. Neben der Erhebung klinischer Befunde, der Bestimmung biochemischer Marker und der Durchführung konventioneller, morphologisch bildgebender Verfahren wie CT, MRT, Sonographie und Endosonographie können nuklearmedizinische, funktionelle Untersuchungen einen entscheidenden Beitrag in Diagnostik, Staging, Follow up und zur Therapieentscheidung liefern. Die breitere Verfügbarkeit der dualen Bildgebung in Form von SPECT/CT und PET/CT hat die nuklearmedizinischen diagnostischen Möglichkeiten noch erweitert, da pathologische Läsionen genau anatomischen Strukturen zugeordnet werden können.
    06/2009; 12(3):18-23. DOI:10.1007/s00740-009-0153-2
  • [Show abstract] [Hide abstract]
    ABSTRACT: In-line combined systems, single-photon emission computed tomography (SPECT)/computed tomography (CT) and positron emission tomography (PET)/CT, allow an instant generation of fused images of scintigraphy and CT data. The accumulated clinical data on the use of these systems in various clinical scenarios indicate that this hybrid technology improves the diagnostic accuracy as compared to scintigraphy and CT alone and even to side-by-side interpretation of scintigraphy and CT, which were acquired separately. The improved diagnostic accuracy is reflected by improving image quality of SPECT and PET, detection of more clinically relevant lesions, better localization of disease and differentiation between physiologic and pathologic uptake, characterization of disease by its functional and morphologic appearance before and after therapy and accurate delineation of disease, optimizing biopsy and therapy planning.
    Seminars in nuclear medicine 08/2009; 39(4):264-75. DOI:10.1053/j.semnuclmed.2009.03.004 · 3.13 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The enhancement of metaiodobenzylguanidine single photon emission computed tomography (MIBG SPECT) imaging through the addition of CT images fused with SPECT data (coregistered MIBG SPECT/CT imaging) is new technology that allows direct correlation of anatomical and functional information. We hypothesized that MIBG SPECT/CT imaging would provide additional information and improve diagnostic confidence for the radiological localization of a pheochromocytoma, in particular for patients at high risk of multifocal or recurrent disease. A retrospective study of all patients investigated by MIBG SPECT/CT at our institution from 2006 to 2008 for a suspected pheochromocytoma was performed. Each case was compared with conventional radiological investigations to determine whether MIBG SPECT/CT was able to improve diagnostic confidence and provide additional diagnostic information compared with conventional imaging alone. Twenty-two patients had MIBG SPECT/CT imaging for a suspected pheochromocytoma. Fourteen patients had positive MIBG SPECT/CT imaging results correlating with imaging by CT or magnetic resonance imaging in all cases. In six cases, MIBG SPECT/CT provided additional information that altered the original radiological diagnosis. Five patients with a pheochromocytoma-associated germline mutation had multifocal disease excluded by MIBG SPECT/CT. Patients without a germline mutation that had positive biochemistry and a solitary lesion with conventional imaging had no diagnostic improvement with MIBG SPECT/CT imaging. MIBG SPECT/CT fusion imaging is a sensitive and specific radiological imaging tool for patients suspected to have pheochromocytoma. The particular strengths of MIBG SPECT/CT are detection of local recurrence, small extra-adrenal pheochromocytomas, multifocal tumors, or the presence of metastatic disease.
    Annals of Surgical Oncology 12/2009; 17(2):392-400. DOI:10.1245/s10434-009-0850-5 · 3.94 Impact Factor
Show more