Somatostatin receptor scintigraphy in the initial staging of low-grade non-Hodgkin's lymphomas.
In this prospective study, somatostatin receptor (SS-R) scintigraphy was compared with conventional staging procedures for the initial staging of patients with low-grade non-Hodgkin's lymphoma (NHL).


METHODS
Fifty consecutive untreated patients with low-grade NHL underwent SS-R scintigraphy as part of their initial staging. Planar images were obtained 24 and 48 h after intravenous injection of 220 MBq (111)In-pentetreotide. SPECT images of the upper abdomen were obtained from all patients. SS-R scans were evaluated blindly without knowledge of the results of the conventional staging methods. SS-R scintigraphy findings were compared with the results of physical and radiologic examinations.


RESULTS
SS-R scintigraphy findings were positive in 42 of 50 patients (84%). In 10 patients (20%), the SS-R scan revealed new lesions that had not been revealed by conventional staging procedures. These 10 patients were all upgraded to a higher stage. Consequently, the treatment plan would have been altered in 5 patients (10%). However, in 19 patients (38%), lesions apparent after conventional staging methods were missed by SS-R scintigraphy. The sensitivity of SS-R scintigraphy varied from 62% for supradiaphragmatic lesions to 44% for infradiaphragmatic lesions. The specificity of SS-R scintigraphy was high (98%-100%). In comparison with CT scanning and sonography, SS-R scintigraphy is inferior for the visualization of NHL lesions in the thorax and abdomen.


CONCLUSIONS
Although SS-R scintigraphy findings are positive in a large proportion of patients with low-grade NHL, in most patients only part of the lesions can be visualized. Because of the limited sensitivity, we recommend SS-R scintigraphy for initial staging of patients with low-grade NHL only in selected conditions and not for the general work-up.
Lugtenburg
P J
PJ
Department of Hematology, Erasmus University, Rotterdam, The Netherlands.
Löwenberg
B
B
Valkema
R
R
Oei
H Y
HY
Lamberts
S W
SW
Eijkemans
M J
MJ
van Putten
W L
WL
Krenning
E P
EP
D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging*; D008297:Male; D009367:Neoplasm Staging; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin / Q000032:analysis*; D012680:Sensitivity and Specificity; D013004:Somatostatin / Q000031:analogs & derivatives*; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
D007205:Indium Radioisotopes; D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin; D013004:Somatostatin; C081788:pentetreotide