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A Journal on Endocrine System Diseases

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Minerva Endocrinoiogica 2009 June;34(2):89-96

language: English

Influence of tumour size and uptake of 99mTc-octreotide on radio-guided surgery for neuroendocrine tumours

Hodolic M. 1, Fettich J. 1, Rubello D. 2

1 Department of Nuclear Medicine University Medical Centre Ljubljana Ljubljana, Slovenia
2 Department of Nuclear Medicine PET Centre Santa Maria della Misericordia Hospital Rovigo, Italy


Aim. The aim of this study was to analyze the influence of scintigraphic uptake grade and tumour size on radio-guided surgery of neuroendocrine tumours (NETs) using 99mTc-EDDA/HYNIC-TOC (99mTc-octreotide).
Methods. We investigated 21 patients with NET (F=8, M=13) for localization of 27 known lesions using a gamma probe. Three to 6 hours before surgery, 550-650 MBq of 99mTc-octreotide was injected followed by immediate imaging prior to surgery. The uptake was graded on a scale from 0-4. Localization was confirmed by endoscopic ultrasound (EUS), computed tomograohy (CT) and/or magnetic resonance imaging (MRI). Morphological images were used to determine size of the lesion. Local measurements of radioactivity were performed during surgery using a gamma probe.
Results. Twenty lesions were successfully localized intraoperatively using a gamma probe (7=grade 4, 9=grade 3, 2=grade 2 and 2=grade 0). The size of successfully localized lesions ranged between 9 and 50 mm. Seven lesions were not localized successfully of which 6 were seen on scintigraphy(2=grade 4, 1=grade 3 and 3=grade 2). The 7th lesion was not seen on preoperative scintigraphy and not localized successfully. The size of unsuccessfully localized lesions ranged between 7 and 30 mm.
Conclusion. High octreotide uptake (grade 3 and 4) influence radioguided surgery. Tumour size did not influence the success of localization of lesions by gamma probe.

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