Detection of bone metastases in patients with endocrine gastroenteropancreatic tumors: bone scintigraphy compared with somatostatin receptor scintigraphy.
Scintigraphy with somatostatin analogs is a sensitive method for the staging and therapeutic management of patients with endocrine gastroenteropancreatic (GEP) tumors. The aim of this study was to compare prospectively somatostatin receptor scintigraphy (SRS) using 111n-pentetreotide with bone scintigraphy using 99mTc-hydroxymethylene diphosphonate for the detection of bone metastases.


METHODS
One-hundred-forty-five patients with proven endocrine GEP tumors were investigated. Patients were classified according to the presence of bone metastases as indicated by CT, MRI or histologic data. Group I included 19 patients with confirmed bone metastases, and group II included 126 patients without bone metastases.


RESULTS
In group I, SRS was positive in all 19 patients with bone metastases, and bone scintigraphy was positive in 17 patients. Bone metastases were found to occur predominantly in patients with liver metastases. In group 11, 5 patients had recent bone surgery for fracture or arthritis. SRS showed bone uptake in 4 of these patients, and bone scanning showed abnormal uptake in 5. In 7 of the remaining 121 group II patients, SRS was negative and bone scanning showed abnormal bone uptake suggesting bone metastases. The detection of bone metastases was of major prognostic value, because 42% of group 1 patients died during a 2-y follow-up.


CONCLUSIONS
In patients with GEP tumors, the accuracy of SRS appears to be similar to that of bone scintigraphy for the detection of bone metastases.
Lebtahi
R
R
Department of Nuclear Medicine, Hôpital Bichat, Paris, France.
Cadiot
G
G
Delahaye
N
N
Genin
R
R
Daou
D
D
Peker
M C
MC
Chosidow
D
D
Faraggi
M
M
Mignon
M
M
Le Guludec
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging; D004067:Digestive System Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000031:analogs & derivatives; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin / Q000378:metabolism*; D013004:Somatostatin / Q000031:analogs & derivatives; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives; D015043:Zollinger-Ellison Syndrome / Q000000981:diagnostic imaging
D007205:Indium Radioisotopes; D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin; C071632:SDZ 215-811; D013004:Somatostatin; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D004369:Pentetic Acid; C081788:pentetreotide; D015282:Octreotide; D013669:Technetium Tc 99m Medronate