Somatostatin receptor scintigraphy screening in advanced hepatocarcinoma: A multi-center French study.
BACKGROUND
Somatostatin receptor scintigraphy (SRS) has been reported for receptor (SSTR) screening in advanced hepatocarcinoma (aHC) prior to somatostatin analogue treatment.


OBJECTIVE
To evaluate SSTR screening with SRS in aHC patients.


RESULTS
Seventy aHC patients (63 men) aged 65 +/- 11 y were included, with alcohol, viral or other causes cirrhosis in 35 (50%), 23 (33%), 12 (17%) cases respectively. CLIP score was 2.7 +/- 1.7, with more than three nodules in 37 (53%) cases. Largest nodule measured 7.6 +/- 4.5 cm. Median alpha-fetoprotein was 574 UI/mL. SRS was positive in 25/70 (35.7%) livers and 7/17 (41.2%) metastatic sites. Positive SRS patients differed from others for tumor size (9.2 +/- 4 vs. 6.7 +/- 4.6 cm, p = 0.03), prothrombin time (PT) (75.2 +/- 15.2 vs. 61.9 +/- 19%, p = 0.005), albumin (34.1 +/- 5.9 vs. 30.5 +/- 7.2 g/L, p = 0.04) and Child-Pugh (6.7 +/- 1.8 vs. 7.7 +/- 2.3, p = 0.04). After multivariate analysis, only PT was associated with positive SRS (p = 0.028). Immunohistochemistry was positive for SSTR2s in 6/7 tumors (SRS uptake in 5/6 cases).


METHODS
SRS was performed prior treatment, with images at 4, 24 and 48 h. For seven tumors, SSTR2 subtype was detected immunohistochemically.


CONCLUSIONS
In advanced hepatocarcinoma, we report SRS uptake in 35.7% of livers and 41.2% of metastatic sites. SRS value in screening patients for somatostatin analogue treatment remains to be assessed.
Nguyen-Khac
Eric
E
Service d'Hépato-Gastroentérologie CHU Amiens, Amiens, France. nguyen-khac.eric@chu-amiens.fr
Ollivier
Isabelle
I
Aparicio
Thomas
T
Moullart
Véronique
V
Hugentobler
Alexis
A
Lebtahi
Rachida
R
Lobry
Céline
C
Susini
Christiane
C
Duhamel
Christian
C
Hommel
Séverine
S
Cadranel
Jean François
JF
Joly
Jean-paul
JP
Barbare
Jean Claude
JC
Tramier
Blaise
B
Dupas
Jean Louis
JL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D005602:France; D006801:Humans; D007150:Immunohistochemistry; D007205:Indium Radioisotopes / Q000493:pharmacokinetics; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011877:Radionuclide Imaging / Q000379:methods; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D017481:Receptors, Somatostatin / Q000032:analysis* / Q000378:metabolism; D013004:Somatostatin / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D016896:Treatment Outcome
D007205:Indium Radioisotopes; D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin; D013004:Somatostatin; C081788:pentetreotide