Impact of 111In-DTPA-octreotide SPECT/CT fusion images in the management of neuroendocrine tumours.
OBJECTIVE
Somatostatin receptor scintigraphy with [(111)In]-diethylene triamine pentaacetate acid (DTPA)-octreotide is an accurate method for detecting neuroendocrine tumours (NETs) but often does not provide clear anatomical localisation of lesions. The aim of this study was to assess the clinical usefulness of anatomical-functional image fusion.


METHODS
Fifty-four patients with known or suspected NET were included in the study. Planar and single-photon-emission computed tomography (SPECT) imaging was performed using a dual-head gamma camera equipped with an integrated X-ray transmission system, and the images were first interpreted alone by two nuclear medicine physicians and then compared with SPECT/CT fusion images together with a radiologist. The improvement provided by SPECT/CT in the interpretation of SPECT data alone and any modification in patient management were recorded.


RESULTS
Fusion images improved SPECT interpretation in 23 cases, providing precise anatomical localisation of increased tracer uptake in 20 cases and disease exclusion in sites of physiological uptake in 5. In 10 patients, SPECT/CT allowed definition of the functional significance of lesions detected by diagnostic CT. SPECT/CT data modified clinical management in 14 cases by changing the diagnostic approach in 8 and the therapeutic modality in 6.


CONCLUSIONS
Our study demonstrates that image fusion is clearly superior to SPECT alone, allowing precise localisation of lesions and reducing false-positive results.
Castaldi
P
P
Istituto di Medicina Nucleare, Dipartimento di Bioimmagini e Scienze Radiologiche, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168 Roma, Italy.
Rufini
V
V
Treglia
G
G
Bruno
I
I
Perotti
G
G
Stifano
G
G
Barbaro
B
B
Giordano
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging*; D015282:Octreotide / Q000031:analogs & derivatives*; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
C497824:111In-octreotide, DTPA(0)-; D007205:Indium Radioisotopes; D019275:Radiopharmaceuticals; D004369:Pentetic Acid; D015282:Octreotide
Nucl Med Commun. 2007 Oct;28(10):782-8
17728608
J Nucl Med. 2001 Jul;42(7):998-1004
11438618
J Nucl Med. 2000 Aug;41(8):1364-8
10945529
Eur J Nucl Med Mol Imaging. 2005 Dec;32(12):1440-51
16133384
Eur J Nucl Med. 2000 Jun;27(6):619-27
10901447
Eur J Nucl Med Mol Imaging. 2004 Oct;31(10):1435-42
15221294
Eur Radiol. 2005 Jul;15(7):1456-62
15627182
Curr Cancer Drug Targets. 2005 Mar;5(2):139-48
15810878
Abdom Imaging. 2004 Nov-Dec;29(6):696-702
15162235
Ann Intern Med. 1996 Jul 1;125(1):26-34
8644985
QJM. 1998 Apr;91(4):295-301
9666953
Clin Endocrinol (Oxf). 2003 Nov;59(5):565-73
14616879
Eur J Nucl Med. 1998 Jun;25(6):639-58
9618580
J Nucl Med. 1997 Aug;38(8):1234-42
9255157
Endocr Rev. 2004 Jun;25(3):458-511
15180952
J Nucl Med. 1997 Jun;38(6):853-8
9189129
Eur J Nucl Med Mol Imaging. 2005 May;32(5):521-4
15747153
Nuklearmedizin. 2004 Oct;43(5):164-70
15480505
Minerva Endocrinol. 2003 Dec;28(4):259-96
14752399
Nucl Med Commun. 2004 Jul;25(7):705-10
15208498
Ann Oncol. 2001;12 Suppl 2:S51-61
11762353
Eur J Nucl Med. 1998 Oct;25(10):1396-403
9818279
Eur J Nucl Med Mol Imaging. 2007 Oct;34(10):1617-26
17520251
Clin Radiol. 2006 Jul;61(7):579-87
16784943
J Nucl Med. 2007 Apr;48(4):508-18
17401086
Semin Nucl Med. 2006 Jul;36(3):228-47
16762613
Trends Pharmacol Sci. 1995 Mar;16(3):86-8
7792934
Eur J Nucl Med Mol Imaging. 2003 Jun;30(6):835-43
12682789