Functional imaging of Langerhans cell histiocytosis by <sup>111</sup>In‐DTPA‐<scp>D</scp>‐Phe<sup>1</sup>‐octreotide scintigraphy

Lastoria, Secondo; Montella, Liliana; Catalano, Lucio; Rotoli, Bruno; Muto, Pietro; Palmieri, Giovannella

doi:10.1002/cncr.10276

Cited by 15 publications

(32 citation statements)

References 49 publications

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“…HRCT is not entirely reliable for identifying inactive disease because, even in patients with cysts as the only visible lesions, granulomas may persist in the pulmonary parenchyma [60]. Recent preliminary results suggest that scintigraphy using indium-111 pentetreotide (a somatostatin analogue) may be useful in assessing lesion activity, although larger studies are needed to determine the role of this investigation in the management strategy [78][79][80].…”

Section: Course and Prognosismentioning

confidence: 99%

Adult pulmonary Langerhans' cell histiocytosis

Tazi¹

2006

European Respiratory Journal

282

297

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Adult pulmonary Langerhans' cell histiocytosis is a rare disorder of unknown aetiology that occurs predominantly in young smokers, with an incidence peak at 20-40 yrs of age. In adults, pulmonary involvement with Langerhans' cell histiocytosis usually occurs as a single-system disease and is characterised by focal Langerhans' cell granulomas infiltrating and destroying distal bronchioles.High-resolution computed tomography (HRCT) of the chest is essential to the diagnosis, typically showing a combination of nodules, cavitated nodules, and thick-and thin-walled cysts. A high macrophage count in bronchoalveolar lavage (BAL) fluid is a common but nonspecific finding that merely reflects exposure to tobacco smoke. BAL is useful for eliminating infections and the other infiltrating lung disorders that can be seen in young adults. Langerhans' cells can be identified in BAL fluid, but, in contrast to what was initially hoped, this test shows a very low sensitivity and is rarely useful in the diagnosis of the disease.The definite diagnosis of pulmonary Langerhans' cell histiocytosis requires identification of Langerhans' cell granulomas, which is usually achieved by surgical lung biopsy at a site selected by chest HRCT. In practice, however, lung biopsy is performed on a case-by-case basis.No effective treatment is available to date, and improved understanding of the mechanisms involved in the pathogenesis of pulmonary Langerhans' cell histiocytosis is urgently needed, and should help in the development of specific therapeutic strategies for patients with this orphan disease.

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Section: Course and Prognosismentioning

confidence: 99%

Adult pulmonary Langerhans' cell histiocytosis

Tazi¹

2006

European Respiratory Journal

282

297

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“…Granulomas in sarcoidosis, tuberculosis, as well as Wegener's granulomatosis can be visualized with high sensitivity, 69,70 evidencing foci missed by conventional radiographic techniques in a subset of patients 71 . Similarly, patients with skeletal or extraskeletal histiocytosis may benefit of SSR scintigraphy 72,73 . The cellular expression of SSRs in granulomas has been evaluated with different techniques, however, immunohistochemistry firstly allowed the particular localization of different receptors on specific cells 70,74 .…”

Section: Significance Of the Somatostin/cortistatin System In Lymphoimentioning

confidence: 99%

Neuroendocrine‐Immune Interactions

Ferone¹

2006

Annals of the New York Academy of Sciences

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Hormones and neuropeptides may influence the activities of lymphoid organs and cells via endocrine and local autocrine/paracrine pathways. A paradigm of the interactions between the neuroendocrine and immune system is sophisticatedly represented in the thymus. Indeed, receptors for these molecules are heterogeneously expressed in all subsets of thymic cells, and the communications are tuned by feedback circuitries. Herein, we focus on somatostatin (SS), a ubiquitous peptide that regulates several physiological cell processes and acts via five specific receptor (SSR) subtypes (sst(1-5)). Neuronal and accessory cells, so-called neuroendocrine cells, and immune cells, heterogeneously express SSRs. The functional characterization of SSRs in vivo by nuclear medicine techniques opened a complex scenario on the significance of SS/SSR pathway in immune system and related diseases. Several studies have established that SSR scintigraphy may benefit patients with chronic inflammatory and granulomatous diseases, as well as lymphoproliferative diseases. The results are sufficiently promising to warrant larger studies aimed at defining the exact role of these techniques. The development of SS analogs with antisecretory and antiproliferative effects has radically changed the management of neuroendocrine tumors. Moreover, very important recent findings, emerging from in vitro studies on SSR physiology in immune cells, will certainly expand the potential applications of SS analogs for in vivo diagnostic and therapeutic options. Indeed, the anti-inflammatory and analgesic effects of these drugs remain incompletely understood, but may prove useful in a number of autoimmune diseases. Because SS expression is absent in different immune tissues where SSRs are present, the existence of another ligand was hypothesized. In fact, it has been recently demonstrated that human lymphoid tissues and immune cells may express cortistatin (CST). CST is known to bind SSRs and shares many pharmacological and functional properties with SS. However, CST has also properties distinct from SS, and the higher expression of CST in immune cells supports the hypothesis that CST rather than SS may act as a potential endogenous ligand for SSRs in the human immune system.

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“…Similarly to octreotide, [ 111 In-DTPA 0 ]-octreotide binds to sst 2 with high affinity and to sst 3 and sst 5 with lower affinity (18). The logical supposition that sst 2 is the receptor mainly responsible for [ 111 In-DTPA 0 ]-octreotide uptake is supported by experimental data (19). However, in some neoplasms, other SSR subtypes may participate in determining the uptake of the radiotracer (20,21).…”

confidence: 92%

“…Commonly, the radiotracer used for SRS is [ 111 In-diethylenetriaminepentaacetic acid (DTPA) 0 ]-octreotide, synthesized linking octreotide to the γ-emitting radionuclide 111 In, with interposition of the chelator molecule DTPA (16,17). Similarly to octreotide, [ 111 In-DTPA 0 ]-octreotide binds to sst 2 with high affinity and to sst 3 and sst 5 with lower affinity (18). The logical supposition that sst 2 is the receptor mainly responsible for [ 111 In-DTPA 0 ]-octreotide uptake is supported by experimental data (19).…”

confidence: 99%

“…Several other radiolabeled SS analogs suitable for SRS have been developed and successfully tested in humans. Such radioanalogs retain the general structure of [ 111 In-DTPA 0 ]-octreotide; however, changes in the amino-acid sequence of the analog and/or the use of different chelators and radionuclide vary the affinity profile of the radiotracers for the 5 SSR (18). Some of the new radioanalogs, such as 99m Tc-depreotide, have entered clinical practice.…”

confidence: 99%

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Somatostatin receptor scintigraphy in thoracic diseases

Ameri

Gatto

Arvigo

et al. 2007

J Endocrinol Invest

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Somatostatin (SS) receptor scintigraphy is useful for the diagnosis of lesions with high density of SS receptors, and above all neuroendocrine tumors. For several years, only indium-labeled octreotide has been applied to visualise in vivo tissues with SS receptor overexpression. Radiolabeled octreotide became the gold standard for the detection of neuroendocrine tumors. More recently, however, several new SS analogues with varying affinity for SS receptor subtypes have been developed, and different radionuclides as radiolabels have been introduced. Moreover, significant improvements have been made by the introduction of hybrid machines, such as single photon emission computed tomography/ computed tomography (SPECT/CT) or positron emission tomography (PET)/CT that enable to perform whole-body imaging quickly and with high anatomical resolution in several body areas, including the chest. The development of more specific radiopharmaceuticals, together with the modern technique of imaging, may provide excellent quality images with high contrast, allowing to depict very small lesions and making them easy to interpret. Indeed, in the management of SS receptor-positive lesions, the contribution of nuclear medicine is essential in several clinical settings, such as initial diagnosis, disease staging, follow-up, treatment planning, and treatment monitoring. In addition, the tracer uptake might be used as a prognostic parameter and as a predictor of treatment response. In the chest, apart in (neuro)endocrine tumors, SS receptors have been demonstrated in granulomatous diseases, like sarcoidosis and other immune-mediated disorders, such as anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis. In this paper we review and discuss the role of SS receptor scintigraphy in diagnosis, staging or follow- up of thoracic SS receptor-positive lesions.

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Functional imaging of Langerhans cell histiocytosis by ¹¹¹In‐DTPA‐D‐Phe¹‐octreotide scintigraphy

Cited by 15 publications

References 49 publications

Adult pulmonary Langerhans' cell histiocytosis

Adult pulmonary Langerhans' cell histiocytosis

Neuroendocrine‐Immune Interactions

Somatostatin receptor scintigraphy in thoracic diseases

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Functional imaging of Langerhans cell histiocytosis by 111In‐DTPA‐D‐Phe1‐octreotide scintigraphy

Cited by 15 publications

References 49 publications

Adult pulmonary Langerhans' cell histiocytosis

Adult pulmonary Langerhans' cell histiocytosis

Neuroendocrine‐Immune Interactions

Somatostatin receptor scintigraphy in thoracic diseases

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Product

Resources

About

Functional imaging of Langerhans cell histiocytosis by ¹¹¹In‐DTPA‐D‐Phe¹‐octreotide scintigraphy