title: Clinical application of SPECT-CT with 99mTc-Tektrotyd in bronchial and thymic neuroendocrine tumors (NETs).
abstract: Neuroendocrine tumors (NETs) of the thorax including bronchial and thymic tumors belong to foregut NETs. Limited loco-regional thoracic NETs can be resected with surgery, but in extensive metastatic disease the treatment is mainly palliative. A high incidence and density of somatostatin receptors (SSTR2, SSTR3, and SSTR5) are found in thoracic NETs. The purpose of this study was to evaluate the role of SPECT-CT somatostatin receptor scintigraphy (SRS) with 99mTc-Tektrotyd for imaging, staging and follow up of patients with bronchial and thymic neuroendocrine tumors. Forty-one patients with thoracic tumors with neuroendocrine differentiation were studied. Sixty-eight examinations including SPECT-CT studies of the neck and chest and/or abdomen and pelvis were carried out 2-4 hrs. post i.v. administration of aver-age 740 MBq activity dose of 99mTc-EDDA/HYNIC-TOC (Tektrotyd, Polatom). In all 41 investigated patients we obtained 81.25% (13/16), 88% (22/25) and 85.36% (35/41) of sensitivity, specificity and accuracy of this diagnostic approach, respectively. Somatostatin-receptor scintigraphy correctly identified all primary NETs located in the lungs and thymus. SPECT-CT studies with 99mTc-EDDA/HYNIC-TOC resulted in exact pre-surgical and pre-treatment N/M staging of bronchial and thymic NETs, except 2 cases with multiple hepatic metastases and 1 with massive suprarenal metastasis. It can be concluded that SPECT-CT with 99mTc-EDDA/HYNIC-TOC is a valuable tool for staging and follow-up of patients with thoracic NETs.
authors.affiliation: Department of Nuclear Medicine, Sofia Cancer Center. sergieva.sonya@yahoo.com.
authors.forename: Sonya
authors.initials: S
authors.lastname: Sergieva
authors.forename: Bozhil
authors.initials: B
authors.lastname: Robev
authors.forename: Milena
authors.initials: M
authors.lastname: Dimcheva
authors.forename: Albena
authors.initials: A
authors.lastname: Fakirova
authors.forename: Radka
authors.initials: R
authors.lastname: Hristoskova
mesh_terms: D000328:Adult; D001984:Bronchial Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000473:pathology; D015282:Octreotide / Q000031:analogs & derivatives*; D015609:Organotechnetium Compounds; D012680:Sensitivity and Specificity; D000072098:Single Photon Emission Computed Tomography Computed Tomography; D013953:Thymus Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D015609:Organotechnetium Compounds; C410263:technetium Tc 99m hydrazinonicotinyl-Tyr(3)-octreotide; D015282:Octreotide
keywords: 99mTc-EDDA/HYNIC-TOC; SPECT-CT; Thymic neuroendocrine tumors; bronchial neuroendocrine tumors