Role of 99mTc-octreotide acetate scintigraphy in suspected lung cancer compared with 18F-FDG dual-head coincidence imaging.
The aim of this study was to evaluate the clinical value of tomographic (99m)Tc-octreotide acetate (hereafter, (99m)Tc-octreotide) scintigraphy in the detection of patients with suspected lung cancer in comparison with that of (18)F-FDG dual-head coincidence imaging (DHC).


METHODS
Forty-four consecutive patients with suspected pulmonary neoplasms underwent tomographic (99m)Tc-octreotide scintigraphy and (18)F-FDG coincidence imaging using the same gantry. The region of interest was drawn on the entire primary lesion. The tumor-to-normal tissue tracer values for both (99m)Tc-octreotide and (18)F-FDG were determined using region of interests and expressed as T/N(r) and T/N(m), respectively. Final diagnosis was confirmed by histopathologic analysis or clinical follow-up.


RESULTS
Thirty-one of the 44 patients had lung cancer-6 with small cell lung cancer (SCLC) and 25 with non-small cell lung cancer (NSCLC). Thirteen of the 44 patients had benign lung lesions. The sensitivity, specificity, positive predictive value, and negative predictive value of (99m)Tc-octreotide were 100%, 75.7%, 90.1%, and 100%, respectively, and of (18)F-FDG DHC were 100%, 46.1%, 83.8%, and 100%, respectively. In the 31 patients with malignant tumors, all 38 abnormal lymph nodes in 20 patients showed abnormal high focal uptake of (18)F-FDG; only 7 patients with 10 regional lymph adenopathies showed moderate uptake of (99m)Tc-octreotide. Thirteen patients with 39 distant sites of abnormal uptake visualized (imaging stage IV) with (99m)Tc-octreotide included 2 patients with brain metastases, 6 patients with pleural invasion and multiple bone metastasis, 2 patients with contralateral internal lung metastasis and pleural invasion, and 3 patients with only multiple bone metastasis. The final diagnosis was confirmed by histopathology or clinical follow-up.


CONCLUSIONS
The sensitivity of (99m)Tc-octreotide for the detection of lung cancer at the primary lesion was comparable with that of (18)F-FDG coincidence imaging. Tomographic (99m)Tc-octreotide scintigraphy had lower sensitivity for the detection of hilar and mediastinal lymph node metastasis compared with that of (18)F-FDG coincidence PET, but it had high sensitivity for the detection of remote metastatic lesions. However, because of the small population, further investigation is necessary.
Wang
Feng
F
Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, 68 Chang-le Road, Nanjing 210006, China.
Wang
Zizheng
Z
Yao
Weixuan
W
Xie
Hong
H
Xu
Jie
J
Tian
Li
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D015282:Octreotide / Q000031:analogs & derivatives*; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals
C493098:99mTc-octreotide; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D015282:Octreotide