Top

European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-10-2006 | Original article

^99mTc-EDDA/HYNIC-octreotate scintigraphy, an efficient method for the detection and staging of carcinoid tumours: results of 3 years’ experience

Authors: A. Hubalewska-Dydejczyk, K. Fröss-Baron, R. Mikołajczak, H. R. Maecke, B. Huszno, D. Pach, A. Sowa-Staszczak, B. Janota, P. Szybiński, J. Kulig

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 10/2006

Abstract

Purpose

At all stages of the disease, serious difficulties are encountered in the imaging diagnosis of carcinoids. Somatostatin receptor scintigraphy (SRS) holds great promise for detecting primary tumours and metastases. ^99mTc-EDDA/HYNIC-octreotate should significantly improve the diagnosis of carcinoids in comparison with ¹¹¹In-Octreoscan owing to the better affinity for SSR2 and the higher count rate. The aim of this study was to assess the diagnostic efficiency of ^99mTc-EDDA/HYNIC-octreotate scintigraphy in the detection and staging of carcinoid tumours.

Methods

The study population comprised 75 patients (age 48.5±15.5 years): 46 with histological confirmation of carcinoid and 29 with suspected disease. ^99mTc-EDDA/HYNIC-octreotate (740 MBq) SRS and CT were performed in all patients. Fifteen patients were examined with ¹¹¹In-Octreoscan.

Results

High-quality ^99mTc-EDDA/HYNIC-octreotate images were obtained in all cases, with maximum tumour tracer accumulation 4 h p.i. The mean target/non-target ratios for whole body (WB) and SPECT scans were, respectively, as follows: primary lesions: 4.5 and 10.2; metastases: liver, 3.1 and 12.3; abdominal focal lesions, 2.7 and 5.8; lung, 2.7 and 8.3; mediastinum, 3.4 and 7.6; bones, 6.8 and 19.0. ^99mTc-EDDA/HYNIC-octreotate WB scans revealed more metastases than ¹¹¹In-Octreoscan, with better individual separation. ^99mTc-EDDA/HYNIC-octreotate SRS revealed new metastatic lesions in seven patients with confirmed carcinoid, and in four with dissemination the primary focus was found. Five patients qualified for radioguided surgery and 11 were referred to ⁹⁰Y-DOTA-TATE therapy. The sensitivity of SRS in comparison with CT was higher for primary lesions and liver and abdominal lymph node metastases. In the subgroup of patients with suspected neuroendocrine tumours, two duodenal carcinoids, one thymic carcinoid and one ileal carcinoid were found.

Conclusion

^99mTc-EDDA/HYNIC-octreotate, with high imaging quality, is an excellent alternative to ¹¹¹In-Octreoscan for staging of carcinoids, and it seems to be the method of choice for detection of the primary focus in patients with metastases from an unknown primary tumour.

Patel YC. Somatostatin and its receptor family. Front Neuroendocrinol 1999;20(3):157–98PubMedCrossRef

Kwekkeboom DJ, Krenning EP, Bakker WH, Oei HY. Somatostatin analogue scintigraphy in carcinoid tumours. Eur J Nucl Med 1993;20(4):283–92CrossRefPubMed

Krenning EP, Kwekkeboom DJ, Bakker WA, Breeman WA, Kooij PP, Oei HY, et al. Somatostatin receptor scintigraphy with [¹¹¹In-DTPA-D-Phe] and [¹²³I-tyr]-octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med 1993;20(8):716–31PubMedCrossRef

Blum J, Handmaker H, Lister-James J, Rinne N. A multi-center trial with a somatostatin analog^99mTc depreotide in the evaluation of solitary pulmonary nodules. Chest 2000;177(5):1232–8CrossRef

Virgolini I, Leimer M, Handmaker H, Lastoria S, Bischof C, Muto P, et al. Somatostatin receptor subtype specificity and in vivo binding of a novel tumor tracer, ^99mTc-P829. Cancer Res 1998;58(9):1850–9PubMed

Behe M, Maecke HR. New somatostatin analogues labelled with technetium-99m [abstract]. Eur J Nucl Med 1995;22:791

Liu S, Edwards DS, Barrett JA.^99mTc labelling of highly potent small peptides. Bioconjugate Chem 1997;8(5):621–36CrossRef

Babich JW, Solomon H, Pike MC, Kroon D, Graham W, Abrams MJ, et al. Technetium-99m-labelled hydrazino nicotinamid derivatized chemotactic peptide analogues for imaging focal sites of bacterial infection. J Nucl Med 1993;34(11):1964–74PubMed

Bangard M, Behe M, Guhlke S, Otte R, Bender H, Maecke HR, et al. Detection of somatostatin receptor-positive tumours using the new ^99mTc-tricine-HYNIC-D-Phe¹-Tyr³-octreotide: first results in patients and comparison with ¹¹¹In DTPA-D-Phe¹-octreotide. Eur J Nucl Med 2000;27(6):628–37CrossRefPubMed

10.

Decristoforo C, Mather JS. Technetium-99m somatostatin analogues: effect of labelling methods and peptide sequence. Eur J Nucl Med 1999;26(8):869–76CrossRefPubMed

11.

Decristoforo C, Mather JS, Cholewinski W, Donnemiller E, Riccabona G, Moncayo R. ^99mTc EDDA/HYNIC-TOC: a new ^99m Tc-labelled radiopharmaceutical for imaging somatostatin receptor-positive tumours: first clinical results and intra-patient comparison with ¹¹¹In-labelled octreotide derivatives. Eur J Nucl Med 2000;27(9):1318–25CrossRefPubMed

12.

Płachcińska A, Mikołajczak R, Maecke HR, Młodkowska E, Kunert-Radek J, Michalski A, et al. Clinical usefulness of ^99mTc EDDA/HYNIC-TOC scintigraphy in oncological diagnostics: a preliminary communication. Eur J Nucl Med Mol Imaging 2003;30(10):1402–6PubMedCrossRef

13.

Reubi JC, Schar JC, Waser B, Wenger S, Heppeler A, Schmitt JS, et al. Affinity profiles for human somatostatin receptor subtypes SST1–SST5 for somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med 2000;27(3):273–82PubMedCrossRef

14.

Kwekkeboom KJ, Bakker WH, Kooij PP, Konijnenberg MW, Srinivasan A, Erion L, et al. [¹⁷⁷Lu-DOTA⁰,Tyr³] octreotate: comparison with [¹¹¹In-DTPA⁰]octreotide in patients. Eur J Nucl Med 2001;28(9):1319–25CrossRefPubMed

15.

Decristoforo C, Maina T, Nock B, Gabriel M, Cordopatis P, Moncayo R. ^99mTc Demotate 1: first data in tumour patients results of a pilot/phase I study. Eur J Nucl Med Mol Imaging 2003;30(9):1211–9PubMedCrossRef

16.

Solcia E, Kloppel G, Sobin LH, et al. Histologic typing of endocrine tumours. WHO International Histological Classification of Tumours. Berlin Heidelberg New York: Springer, 2000

17.

Ramage JK, Davies AH, Ardill J, Bax N, Caplin M, Grossman A, et al. UK NETwork for Neuroendocrine Tumours. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours. Gut 2005;54(Suppl 4):iv1–iv16CrossRefPubMed

18.

Kuwada SK. Carcinoid tumours. Semin Gastrointest Dis 2000;11(3):157–61PubMed

19.

Benjegärd SA, Forssell-Aronsson E, Wängberg B, Skänberg J, Nilsson O, Ahlman H. Intraoperative tumour detection using ¹¹¹In DTPA-D-Phe-octreotide and scintillation a detector. Eur J Nucl Med 2001;28(10):1456–62CrossRefPubMed

20.

Adams S, Baum RP. Intraoperative use of gamma-detecting probes to localize neuroendocrine tumors. Q J Nucl Med 2000;44(1):59–67PubMed

21.

Cholewinski W, Kowalczyk JR, Stefaniak B, Stefaniak J, Poniatowicz-Frasunek E, Tarkowska A. Diagnosis and staging of children’s lymphoma using the technetium-labelled somatostatin analogue,^99mTc-depreotide. Eur J Nucl Med Mol Imaging 2004;31(6):820–4CrossRefPubMed

22.

Shi W, Johnston CF, Buchanan KD, Ferguson WR, Laird JD, Crothers JG, McIlrath EM. Localization of neuroendocrine tumours with [¹¹¹In]DTPA-octreotide scintigraphy (Octreoscan): a comparative study with CT and MR imaging. Q J Med 1998;91(4):295–301

23.

Chiti A, Fanti S, Savelli G, Romeo A, Bellanova B, Rodari M, et al. Comparison of somatostatin receptor imaging, computed tomography and ultrasound in the clinical management of neuroendocrine gastro-entero-pancreatic tumours. Eur J Nucl Med 1998;25(10):1396–403CrossRefPubMed

24.

Caplin ME, Buscombe JR, Hilson AJ, Jones AL, Watkinson AF, Burroughs AK. Carcinoid tumour. Lancet 1998;352(9130):799–805CrossRefPubMed

25.

Schillaci O, Spanu A, Scopinaro F, Falchi A, Danieli R, Marongiu P, et al. Somatostatin receptor scintigraphy in liver metastasis detection from gastroenteropancreatic neuroendocrine tumors. J Nucl Med 2003;44(3):359–68PubMed

26.

Soga J. Early-stage carcinoids of the gastrointestinal tract: an analysis of 1914 reported cases. Cancer 2005;15:103(8):1587–595CrossRef

27.

Vinik A. Carcinoid tumors. http://www.endotext.com/guthormones/guthormone2/guthormoneframe2.htm

28.

Zuetenhorst JM, Taal BG. Metastatic carcinoid tumors: a clinical review. Oncologist 2005;10(2):123–31CrossRefPubMed

29.

Paganelli G, Zoboli S, Cremonesi M, Bodei L, Ferrari M, Grana C, Bartolomei M. Receptor-mediated radiotherapy with⁹⁰Y-DOTA-D-Phe¹-Tyr³-octreotide. Eur J Nucl Med 2001;28(4):426–34CrossRefPubMed

30.

Fueger BJ, Hamilton G, Raderer M, Pangerl T, Traub T, Angelberger P, et al. Effects of chemotherapeutic agents on expression of somatostatin receptors in pancreatic tumor cells. J Nucl Med 2001;42(12):1856–62PubMed

31.

Amthauer H, Ruf J, Bohmig M, Lopez-Hanninen E, Rohlfing T, Wernecke KD, et al. Diagnosis of neuroendocrine tumours by retrospective image fusion: is there a benefit? Eur J Nucl Med Mol Imaging 2004;31(3):342–8CrossRefPubMed

32.

Hofmann M, Maecke H, Börner AR, Weckesser E, Schöffski P, Oei L, et al. Biokinetics and imaging with the somatostatin receptor PET radioligand ⁶⁸Ga-DOTATOC: preliminary data. Eur J Nucl Med 2001;28(12):1751–7CrossRefPubMed

33.

Kowalski J, Henze M, Schuhmacher J, Macke HR, Hofmann M, Haberkorn U. Evaluation of positron emission tomography imaging using [⁶⁸Ga]-DOTA-D Phe¹-Tyr³-octreotide in comparison to [¹¹¹In]-DTPAOC SPECT. First results in patients with neuroendocrine tumors. Mol Imaging Biol 2003;5(1):42–8CrossRefPubMed

34.

Öberg K, Eriksson B. Nuclear medicine in the detection, staging and treatment of gastrointestinal carcinoid tumours. Best Pract Res Clin Endocrinol Metab 2005;19(2):265–76CrossRefPubMed

Title: 99mTc-EDDA/HYNIC-octreotate scintigraphy, an efficient method for the detection and staging of carcinoid tumours: results of 3 years’ experience
Authors: A. Hubalewska-Dydejczyk
K. Fröss-Baron
R. Mikołajczak
H. R. Maecke
B. Huszno
D. Pach
A. Sowa-Staszczak
B. Janota
P. Szybiński
J. Kulig
Publication date: 01-10-2006
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 10/2006
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-006-0113-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

^99mTc-EDDA/HYNIC-octreotate scintigraphy, an efficient method for the detection and staging of carcinoid tumours: results of 3 years’ experience

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 10/2006

Radionuclide imaging of spinal infections

Enhanced accumulation of long-circulating liposomes modified with the nucleosome-specific monoclonal antibody 2C5 in various tumours in mice: gamma-imaging studies

O-[18F]fluoromethyl-L-tyrosine is a potential tracer for monitoring tumour response to chemotherapy using PET: an initial comparative in vivo study with deoxyglucose and thymidine

Influence of Pi3-K and PKC activity on 99mTc-(V)-DMSA uptake: correlation with tumour aggressiveness in an in vitro malignant glioblastoma cell line model

Detection of pacemaker and lead infection with FDG-PET

Hepatobiliary function assessed by 99mTc-mebrofenin cholescintigraphy in the evaluation of severity of steatosis in a rat model