Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Japanese Journal of Radiology
Published in: Japanese Journal of Radiology 5/2024

12-02-2024 | Neuroendocrine Tumor | Original Article

Combined visual and quantitative assessment of somatostatin receptor scintigraphy for staging and restaging of neuroendocrine tumors

Authors: Yuya Ueki, Hideki Otsuka, Tamaki Otani, Ryosuke Kasai, Yoichi Otomi, Daiki Ikemitsu, Shota Azane, Yamato Kunikane, Takanori Bando, Noritake Matsuda, Yasuyuki Okada, Tetsuji Takayama, Masafumi Harada

Published in: Japanese Journal of Radiology | Issue 5/2024

Login to get access

Abstract

Purpose

Somatostatin receptor scintigraphy (SRS) using 111In-DTPA-DPhe1-octreotide (pentetreotide) has become an integral part of neuroendocrine neoplasm management. The lack of precise quantification is a disadvantage of SRS. This study aimed to adapt the standardized uptake value (SUV) to SRS, establish the SUV range for physiological uptake in the liver, kidney, and spleen, and elucidate the utility of combined visual and quantitative SRS assessment for staging and restaging of neuroendocrine tumors (NETs).

Materials and methods

This study included 21 patients with NETs who underwent 111In-pentetreotide SRS. The SUV of physiological and pathological uptake was calculated using bone single-photon emission computed tomography (SPECT) quantitative analysis software (GI-BONE). For visual analysis, the primary and metastatic lesions were scored visually on planar and SPECT images using a five-point scale. We assessed the relationships between the SUVs of the liver, kidney, and spleen in the dual phase, and among quantitative indices, visual score, and pathological lesions classification.

Results

Sixty-three NEN lesions were evaluated. The mean ± standard deviation maximum SUVs (SUVmax) were liver: 4 h, 2.6 ± 1.0; 24 h, 2.2 ± 1.0; kidney: 4 h, 8.9 ± 1.8; 24 h, 7.0 ± 2.0; and spleen; 4 h, 11.3 ± 4.5; 24 h, 11.5 ± 7.6. Higher SUVmax was significantly associated with higher visual scores on dual-phase SPECT (4 h, p < 0.001; 24 h, p < 0.001) (4 h: scores 3 and 4, p < 0.05; scores 3 and 5: p < 0.01; scores 4 and 5: p < 0.01; 24 h: scores 3 and 4, p = 0.0748; scores 3 and 5: p < 0.01; scores 4 and 5: p < 0.01).

Conclusion

We adapted the SUV to SRS and established the range of SUV for physiological uptake in the liver, kidney, and spleen. Combined visual and quantitative assessment is useful for imaging individual lesions in greater detail, and may serve as a new tumor marker of SRS for staging and restaging of NETs.
Literature
1.
Ito T, Masui T, Komoto I, Doi R, Osamura RY, Sakurai A, et al. JNETS clinical practice guidelines for gastroenteropancreatic neuroendocrine neoplasms: diagnosis, treatment, and follow-up: a synopsis. J Gastroenterol. 2021;56:1033–44.CrossRefPubMedPubMedCentral
2.
Dasari A, Shen C, Halperin D, Zhao B, Zhou S, Xu Y, et al. Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol. 2017;3:1335–42.CrossRefPubMedPubMedCentral
3.
Wang R, Zheng-Pywell R, Chen HA, Bibb JA, Chen H, Rose JB. Management of gastrointestinal neuroendocrine tumors. Clin Med Insights Endocrinol Diabetes. 2019;12:1179551419884058.CrossRefPubMedPubMedCentral
4.
Baumann T, Rottenburger C, Nicolas G, Wild D. Gastroenteropancreatic neuroendocrine tumours (GEP-NET) - imaging and staging. Best Pract Res Clin Endocrinol Metab. 2016;30:45–57.CrossRefPubMed
5.
Mikołajczak R, Maecke HR. Radiopharmaceuticals for somatostatin receptor imaging. Nucl Med Rev Cent East Eur. 2016;19:126–32.CrossRefPubMed
6.
Krenning EP, Valkema R, Kooij PP, Breeman WA, Bakker WH, deHerder WW, et al. Scintigraphy and radionuclide therapy with [indium-111-labelled-diethyl triamine penta-acetic acid-D-Phe1]-octreotide. Ital J Gastroenterol Hepatol. 1999;31:S219–23.PubMed
7.
Bando R, Otsuka H, Otani T, Matsuda N, Azane S, Kunikane Y, et al. A new quantitative index in the diagnosis of Parkinson syndrome by dopamine transporter single-photon emission computed tomography. Ann Nucl Med. 2021;35:504–13.CrossRefPubMed
8.
Matsuda N, Otsuka H, Otani T, Azane S, Kunikane Y, Otomi Y, et al. New quantitative indices of cardiac amyloidosis with 99mTc-pyrophosphate scintigraphy. Jpn J Radiol. 2023;41:428–36.CrossRefPubMed
9.
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;44:359–68.PubMed
10.
11.
Kubota K, Okasaki M, Minamimoto R, Miyata Y, Morooka M, Nakajima K, et al. Lesion-based analysis of (18)F-FDG uptake and (111)In-Pentetreotide uptake by neuroendocrine tumors. Ann Nucl Med. 2014;28:1004–10.CrossRefPubMedPubMedCentral
12.
Chougnet CN, Leboulleux S, Caramella C, Lumbroso J, Borget I, Déandreis D, et al. Frequency and characterization of gastro-entero-pancreatic neuroendocrine tumor patients with high-grade of uptake at somatostatin receptor scintigraphy. Endocr Relat Cancer. 2013;20:229–39.CrossRefPubMed
13.
Weber M, Telli T, Kersting D, Seifert R. Prognostic implications of PET-derived tumor volume and uptake in patients with neuroendocrine tumors. Cancers (Basel). 2023;15:3581.CrossRefPubMed
14.
Sanli Y, Garg I, Kandathil A, Kendi T, Zanetti MJB, Kuyumcu S, et al. Neuroendocrine tumor diagnosis and management: 68Ga-DOTATATE PET/CT. AJR Am J Roentgenol. 2018;211:267–77.CrossRefPubMed
15.
Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: evolving Considerations for PET response criteria in solid tumors. J Nucl Med. 2009;50:122S-S150.CrossRefPubMed
16.
Jh O, Lodge MA, Wahl RL. Practical PERCIST: a simplified guide to PET response criteria in solid tumors 1.0. Radiology. 2016;280:576–84.CrossRef
17.
Martínez A, Infante JR, Quirós J, Rayo JI, Serrano J, Jiménez P, et al. Prognostic value of PERCIST and PET/CT metabolic parameters after neoadjuvant treatment in patients with esophageal cancer. Rev Esp Med Nucl Imagen Mol (Engl Ed). 2022;41:360–7.PubMed
18.
Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: revised RECIST guideline version 1.1. Eur J Cancer. 2009;45:228–47.CrossRefPubMed
19.
20.
Hofman MS, Lau WF, Hicks RJ. Somatostatin receptor imaging with 68ga DOTATATE PET/CT: clinical utility, normal patterns, pearls, and pitfalls in interpretation. Radiographics. 2015;35:500–16.CrossRefPubMed
21.
Kratochwil C, Stefanova M, Mavriopoulou E, Holland-Letz T, Dimitrakopoulou-Strauss A, Afshar-Oromieh A, et al. SUV of [68ga]DOTATOC-PET/CT predicts response probability of PRRT in neuroendocrine tumors. Mol Imaging Biol. 2015;17:313–8.CrossRefPubMed
22.
Wetz C, Apostolova I, Steffen IG, Hofheinz F, Furth C, Kupitz D, et al. Predictive value of asphericity in pretherapeutic [111In]DTPA-octreotide SPECT/CT for response to peptide receptor radionuclide therapy with [177Lu]DOTATATE. Mol Imaging Biol. 2017;19:437–45.CrossRefPubMed
23.
Hicks RJ, Kwekkeboom DJ, Krenning E, Bodei L, Grozinsky-Glasberg S, Arnold R, et al. ENETS consensus guidelines for the standards of care in neuroendocrine neoplasia: peptide receptor radionuclide therapy with radiolabeled somatostatin analogues. Neuroendocrinology. 2017;105:295–309.CrossRefPubMed
24.
Binderup T, Knigge U, Loft A, Mortensen J, Pfeifer A, Federspiel B, et al. Functional imaging of neuroendocrine tumors: a head-to-head comparison of somatostatin receptor scintigraphy, 123I-MIBG scintigraphy, and 18F-FDG PET. J Nucl Med. 2010;51:704–12.CrossRefPubMed
25.
Squires MH 3rd, Volkan Adsay N, Schuster DM, Russell MC, Cardona K, Delman KA, et al. Octreoscan versus FDG-PET for neuroendocrine tumor staging: a biological approach. Ann Surg Oncol. 2015;22:2295–301.CrossRefPubMed
26.
Buchmann I, Henze M, Engelbrecht S, Eisenhut M, Runz A, Schäfer M, et al. Comparison of 68ga-DOTATOC PET and 111In-DTPAOC (Octreoscan) SPECT in patients with neuroendocrine tumours. Eur J Nucl Med Mol Imaging. 2007;34:1617–26.CrossRefPubMed
27.
Ortega C, Wong RKS, Schaefferkoetter J, Veit-Haibach P, Myrehaug S, Juergens R, et al. Quantitative 68Ga-DOTATATE PET/CT parameters for the prediction of therapy response in patients with progressive metastatic neuroendocrine tumors treated with 177Lu-DOTATATE. J Nucl Med. 2021;62:1406–14.CrossRefPubMedPubMedCentral
28.
Hope TA, Calais J, Zhang L, Dieckmann W, Millo C. 111In-pentetreotide scintigraphy versus 68Ga-DOTATATE PET: impact on Krenning scores and effect of tumor burden. J Nucl Med. 2019;60:1266–9.CrossRefPubMedPubMedCentral
Metadata
Title
Combined visual and quantitative assessment of somatostatin receptor scintigraphy for staging and restaging of neuroendocrine tumors
Authors
Yuya Ueki
Hideki Otsuka
Tamaki Otani
Ryosuke Kasai
Yoichi Otomi
Daiki Ikemitsu
Shota Azane
Yamato Kunikane
Takanori Bando
Noritake Matsuda
Yasuyuki Okada
Tetsuji Takayama
Masafumi Harada
Publication date
12-02-2024
Publisher
Springer Nature Singapore
Published in
Japanese Journal of Radiology / Issue 5/2024
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-024-01529-z

Other articles of this Issue 5/2024

Japanese Journal of Radiology 5/2024 Go to the issue

Original Article

Systematic training of LI-RADS CT v2018 improves interobserver agreements and performances in LR categorization for focal liver lesions

Original Article

MRI findings of malignant transformation arising from mature cystic teratoma of the ovary: comparison with benign mature cystic teratoma

Original Article

Clinical value of [18F]AlF-NOTA-FAPI-04 PET/CT for assessing early-stage liver fibrosis in adult liver transplantation recipients compared with chronic HBV patients

Original Article

Growth speed of large brain metastases between diagnostic and radiosurgical planning MRI and predictors of rapid tumor growth

Original Article

Diagnosis of skull-base invasion by nasopharyngeal tumors on CT with a deep-learning approach

Original Article

Diagnostic approach with Z-score mapping to reduce artifacts caused by cerebral atrophy in regional CBF assessment of mild cognitive impairment (MCI) and Alzheimer's disease by [99mTc]-ECD and SPECT