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Nuklearmedizin 2017; 56(03): 97-107
DOI: 10.3413/Nukmed-0851-16-10
Original article
Schattauer GmbH

Incremental value of 99mTc-HYNICTOC SPECT/CT over whole-body planar scintigraphy and SPECT in patients with neuroendocrine tumours

Mehrwert der 99mTc-HYNIC-TOC SPECT/CT gegenüber planarer Ganzkörper-Szintigraphie (GK) und SPECT bei Patienten mit neuroendokrinen Tumoren
Mate Trogrlic
1   Department of Nuclear Medicine, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb , Croatia
,
Stanko Težak
1   Department of Nuclear Medicine, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb , Croatia
› Author Affiliations
Further Information

Publication History

received: 02 October 2016

accepted in revised form: 16 January 2017

Publication Date:
02 January 2018 (online)

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Summary

Aim: The aim of this study was to evaluate the additional value of 99mTc-HYNIC-TOC SPECT/CT over planar whole-body (WB) scintigraphy and SPECT alone in the detection and accurate localisation of neuroendocrine tumour (NET) lesions. Methods: This study included 65 patients with a definitive histological diagnosis of NET prior to scintigraphy. Planar WB scintigraphy, SPECT, and SPECT/CT images were acquired at 4 h postadministration of 670 MBq 99mTc-HYNIC- TOC. Additional SPECT images at 10 min after tracer administration were also acquired. Clinical and imaging follow-up findings were considered as the reference standards (minimum follow-up period, 15 months). Patient and lesion-based analyses of the efficacies of the imaging modalities were performed. Results: While 38 patients exhibited metastasis of NETs, 27 presented no evidence of metastasis. Upon patient- based analysis, the sensitivity and specificity of SPECT/CT were found to be 88.9 and 79.3 %, respectively. The diagnostic accuracies of WB scintigraphy, 4h-SPECT, and SPECT/CT were 72.3, 73.8, and 84.6 %o, respectively. The area under curve (AUC) value for SPECT/CT (0.84) was the highest, followed by those for 4h-SPECT (0.75) and WB scintigraphy (0.74). The accuracy and AUC values of SPECT/CT were significantly better compared to those of WB scintigraphy (p < 0.001), 10 min-SPECT (p < 0.001), and 4 h-SPECT (p = 0.001). The findings of SPECT/CT led to the change in treatment plan of 11 patients (16.9 %o). Conclusion: The sensitivity and diagnostic accuracy of SPECT/CT in the evaluation of NET lesions outperforms planar WB imaging or SPECT alone.

Zusammenfassung

Ziel: Das Ziel dieser Studie war den Mehrwert von 99mTc-HYNIC-TOC SPECT/CT gegenüber planarer Ganzkörper-Szintigraphie (GK) und SPECT alleine zur Erkennung und genauen Lokalisation von Läsionen bei neuroendokri- nen Tumoren (NET) zu untersuchen. Methoden: Diese Studie umfasste 65 Patienten mit einer vor der Szintigraphie histologisch gesicherten Diagnose von NET. Planare-GK-Szin- tigraphie, SPECT und SPECT/CT wurden 4 Stunden nach der Verabreichung von 670 MBq 99mTc-HYNIC-TOC durchgeführt. Zusätzliche SPECT-Bilder 10 min nach der Radiopharmakon-Applikation wurden ebenfalls aufgenommen. Als Referenzstandards dienten die klinischen und Imaging-Follow-up-Er- gebnisse (Mindest-Follow-up-Zeitraum: 15 Monate). Patienten- und Läsions-basierte Analysen des diagnostischen Wertes der Bild- gebungsmodalitäten wurden durchgeführt. Ergebnisse: 38 Patienten hatten Metastasen. 27 zeigten kein Hinweis auf eine Metastasierung. Die Patienten-basierte Analyse bei SPECT/CT ergab eine Sensitivität von 88,9 °% und Spezifität von 79,3 °%. Die diagnostische Genauigkeit der GK-Szintigraphie, SPECT-4h bzw. SPECT/CT war 72,3, 73,8 bzw. 84,6 %. Der AUC-Wert (Area under the curve) war für SPECT/CT am höchsten. Die Genauigkeit und AUC-Werte der SPECT/CT waren signifikant höher als die Werte von GK-Szintigraphie (p < 0,001), 10 min-SPECT (p < 0,001) und 4 h-SPECT (p = 0,001). Die Ergebnisse der SPECT/CT führten zu Änderungen im Behandlungsplan bei 11 Patienten (16,9 °%). Schlussfolgerung: Die SPECT/CT zeigte bei der Beurteilung von NET-Läsionen eine höhere Sensi- tivität und diagnostische Genauigkeit als GK- Szintigraphie und SPECT alleine.

Keywords

neuroendocrine tumours - receptors somatostatin - technetium 99m EDDA-HYNIC-Tyr(3)-octreotide

Schlüsselwörter

neuroendokrine Tumoren - Somatostatin-Rezeptor-Szintigraphie - Technetium 99m EDDAHYNIC-Tyr (3)-Octreotid
 

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