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Rivista di Medicina Nucleare e Imaging Molecolare

A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the Society of Radiopharmaceutical Sciences and to the International Research Group of Immunoscintigraphy
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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2012 February:56(1):90-8

lingua: Inglese

Clinical indications to the use of 99mTc-EDDA/HYNIC-TOC to detect somatostatin receptor-positive neuroendocrine tumors

Parisella M. G. 1, Chianelli M. 2, 3, D’Alessandria C. 1, Todino V. 2, Mikolajczak R. 4, Papini E. 2, Dierckx R. A. 3, Scopinaro F. 1, Signore A. 1, 3

1 Department of Nuclear Medicine, S. Andrea Hospital, Second Faculty of Medicine, Sapienza University, Roma, Italy;
2 Regina Apostolorum Hospital, Albano Laziale, Rome, Italy;
3 Department of Nuclear Medicine and Molecular Imaging, University of Groningen, UMCG, Groningen, The Netherlands;
4 IEA POLATOM Radioisotope Centre, Swierk, Poland


The aim of this study was to define, retrospectively, the utility to perform 99mTc-EDDA/HYNIC-Tyr3-octreotide (99mTc-EDDA/HYNIC-TOC) scan in patients with NET. We studied 50 consecutive patients affected by different types of NET and divided in two groups. Group 1: 34 patients with known lesions in which 99mTc-EDDA/HYNIC-TOC was performed for staging, characterisation or to choose the appropriate treatment. Group 2: 16 patients suspected of having NET or in follow up after surgery. Patients were injected with 370 MBq of 99mTc-EDDA/HYNIC-Tyr3-octreotide and whole-body and SPET images acquired 2-3 hours after injection. Overall, 29 patients (58%) had a positive scan, with a sensitivity, specificity and accuracy of 70.3%, 76.9% and 72%, respectively (78.1%, 50% and 76.5%, in group 1 and 20%, 81.2%, 62.5% in group 2). In patients from group 1 99mTc-HYNIC-TOC scintigraphy showed a concordance of 68% with another imaging procedure and in 9 patients revealed a greater number of lesions. In the second group, false negative results were especially found in patients with medullary thyroid cancer with negative radiological findings and elevated calcitonin. In conclusion, 99mTc-EDDA/HYNIC-TOC is highly indicated for in vivo histological characterization of known NET lesions, previously identified by other imaging modalities or biopsy, to plan appropriate therapy especially for patients with inoperable disease. In patients with only biochemical suspicion of NET and in those with negative markers, this scintigraphy does not significantly modify the clinical management.

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