The aim of investigation was to assess the role of somatostatin receptor
scintigraphy in diagnosis and follow-up of pancreatic neuroendocrine
neoplasms. Somatostatin receptor scintigraphy was performed with 740 MBq
99mTc-EDDA/HYNIC TOC for diagnosis of primary tumors and follow-up after
the therapy. There were 63 true positive, 24 true negative, 4 false
positive, and 6 false negative findings. Sensitivity was 91.3 %, specificity
85.7 %, positive predictive value 94.0 %, negative predictive value 80.0 %,
accuracy 89.7 %. The SPECT contributed diagnosis in 28 true positive
findings. In 32 patients (33 %) somatostatin receptor scintigraphy
significantly changed the management of the patients (10 had surgery, in 17
somatostatin analogues, and in 5 peptide receptor radionuclide therapy was
introduced). Mean Ki-67 index in true positive patients was 13.8 ?5.0 %
while in true negative 7.1 ? 3.4% which is significantly lower at p < 0.05. There
was significantly (p < 0.01) higher number of increased chromogranin A
values in true positive than in true negative patients (p = 0.000857). Our
results confirmed the value of SRS in the diagnosis and follow-up of the patients with pancreatic neuroendocrine neoplasms PanNEN if primary tumors, recurrences or metastases are suspected, as well as for appropriate
choice of the therapy.
Introduction/Objective. Nuclear Medicine Section of IAEA has developed the
software for dynamic renal scintigraphy, which allows calculation of
advanced parameters of drainage: renal output efficiency (OE) and normalized
residual activity (NORA). The aim of this study was to validate IAEA
software by comparing results of parameters of renal drainage in normal
subjects against their established reference values and to assess diagnostic
accuracy of OE and NORA in distinguishing between obstruction/unobstruction.
Methods. 55 patients with suspected obstruction and 36 kidney donors were
investigated. Group A consisted of 24 obstructed kidneys, Group B of 37
kidneys with dilated urinary tract and Group C of 72 normal kidneys. 40min
acquisition was applied. Furosemide was administered after 20min.
Post-micturition image was acquired at 50min. Parameters analyzed were: OE
at 20min (OE20) and at the end of furosemide test (OE40), NORA at 20min
(NORA20) and after micturition (NORAPM). One-way ANOVA was used for
evaluating differences between Groups. Ability of OE40 and NORAPM to
distinguish between obstruction/unobstruction was determined by ROC curve
analysis. The sensitivity, specificity, area under the curve and cutoff
values were analyzed. Results. Excellent agreement of our results with
established OE and NORA values was found. Difference between Groups was
significant for OE20, OE40 NORA20 and NORAPM (p < 0.001). Cut-off values for
obstruction were 82% and 0.11 for OE40 and NORAPM, respectively.
Conclusion. IAEA software gives reliable analysis of diuretic renography and
helps to better diagnose obstruction. IAEA should be encouraged to produce
final version of the software and to release it through Web site.
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