^99mTc-EDDA/HYNIC-Octreotate in Detection of Atypical Bronchial Carcinoid

Abstract

Pulmonary carcinoids cause serious difficulties in imaging diagnostics in all stages of the disease. SRS holds great promise for detecting occult primary tu and metastatic lesions. ^99mTc-EDDA/HYNIC- octreotate, a new scintigraphic agent, should significantly improve sensitivity of the diagnostics of carcinoids due to better affinity to SSR2 than ¹¹¹In-Octreoscan and the higher count rate obtained from ^99mTc over ¹¹¹In. We present a case of a 40-year-old women operated on because of lung carcinoid tumour in 2002. The symptoms did not resolve after the operation and 5-OHIAA was still elevated. The thorax spiral CT revealed the focal lesion beneath carina. ¹¹¹In-Octreoscan and ^99mTc-EDDA/HYNIC-octreotate SRS revealed two focal lesions in the mediastinum. ^99mTc-EDDA/HYNIC-octreotate detected two additional lesions in the lower part of the right lung. Target/non-target count ratios of the lesions were as follows: ^99mTc-EDDA/HYNIC-octreotate scans - 2,9, ¹¹¹In-Octreoscan- 2,1. PET-FDG examination revealed no pathology. Owing to severe bone pains and carcinoid symptoms the patient was referred for the 90Y-DOTA-octreotate treatment. Conclusions: SRS with a new 99mTc marked somatostatin analogue - octreotate allows for a more sensitive detection of metastatic leasions in carcinoid tumours. The usefulness of 18F-FDG PET, widely used as a powerful imaging technique in clinical oncology, is limited in detection of carcinoid tumours due to the low proliferative activity.

Key words

cancer - 99mTc-EDDA/HYNIC-octreotate - SRS - atypical bronchial carcinoid

References

• 1 Kosmidis PA. Treatment of carcinoid of the lung.  Curr Opin Oncol. 2004;  16 146-149
• 2 Bini A, Grazia M, Stella F. et al . The role of somatostatin receptor scintigraphy (Octreoscan) during follow-up of patients after bronchial carcinoid resection. A prospective study.  J Cardiovasc Surg (Torino). 2005;  46 318-319
• 3 Kwekkeboom KJ, Bakker WH, Kooij PP. et al . [¹⁷⁷Lu-DOTA⁰,Tyr³] octreotate: comparison with [¹¹¹In-DTPA⁰]octreotide in patients.  Eur J Nucl Med. 2001;  28 1319-1325
• 4 Paganelli G, Zoboli S, Cremonesi M. et al . Receptor-mediated radiotherapy with 90Y-DOTA-D-Phe1-Tyr3-octreotide.  Eur J Nucl Med. 2001;  28 426-434

Correspondence