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Functional imaging of neuroendocrine tumors: a head-to-head comparison of somatostatin receptor scintigraphy, 123I-MIBG scintigraphy, and 18F-FDG PET.
- Source :
-
Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2010 May; Vol. 51 (5), pp. 704-12. Date of Electronic Publication: 2010 Apr 15. - Publication Year :
- 2010
-
Abstract
- Unlabelled: Functional techniques are playing a pivotal role in the imaging of cancer today. Our aim was to compare, on a head-to-head basis, 3 functional imaging techniques in patients with histologically verified neuroendocrine tumors: somatostatin receptor scintigraphy (SRS) with (111)In-diethylenetriaminepentaacetic acid-octreotide, scintigraphy with (123)I-metaiodobenzylguanidine (MIBG), and (18)F-FDG PET.<br />Methods: Ninety-six prospectively enrolled patients with neuroendocrine tumors underwent SRS, (123)I-MIBG scintigraphy, and (18)F-FDG PET on average within 40 d. The functional images were fused with low-dose CT scans for anatomic localization, and the imaging results were compared with the proliferation index as determined by Ki67.<br />Results: The overall sensitivity of SRS, (123)I-MIBG scintigraphy, and (18)F-FDG PET was 89%, 52%, and 58%, respectively. Of the 11 SRS-negative patients, 7 were (18)F-FDG PET-positive, of which 3 were also (123)I-MIBG scintigraphy-positive, giving a combined overall sensitivity of 96%. SRS also exceeded (123)I-MIBG scintigraphy and (18)F-FDG PET based on the number of lesions detected (393, 185, and 225, respectively) and tumor subtypes. (123)I-MIBG scintigraphy was superior to (18)F-FDG PET for ileal neuroendocrine tumors, and (18)F-FDG PET was superior to (123)I-MIBG scintigraphy for pancreaticoduodenal neuroendocrine tumors. The sensitivity of (18)F-FDG PET (92%) exceeded that of both SRS (69%) and (123)I-MIBG scintigraphy (46%) for tumors with a proliferation index above 15%.<br />Conclusion: The overall sensitivity of (123)I-MIBG scintigraphy and (18)F-FDG PET was low compared with SRS. However, for tumors with a high proliferation rate, (18)F-FDG PET had the highest sensitivity. The results indicate that, although SRS should still be the routine method, (18)F-FDG PET provides complementary diagnostic information and is of value for neuroendocrine tumor patients with negative SRS findings or a high proliferation index.
- Subjects :
- Adult
Aged
Aged, 80 and over
Cell Proliferation
Female
Humans
Image Processing, Computer-Assisted
Immunohistochemistry
Ki-67 Antigen
Male
Middle Aged
Positron-Emission Tomography
Prospective Studies
Tomography, Emission-Computed
3-Iodobenzylguanidine
Fluorodeoxyglucose F18
Neuroendocrine Tumors diagnostic imaging
Radiopharmaceuticals
Receptors, Somatostatin metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1535-5667
- Volume :
- 51
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of nuclear medicine : official publication, Society of Nuclear Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 20395333
- Full Text :
- https://doi.org/10.2967/jnumed.109.069765