The utility of 99mTc-EDDA/HYNIC-TOC scintigraphy for assessment of lung lesions in patients with neuroendocrine tumors

Abstract

Our aim was to assess clinical utility of 99m Tc-EDDA/HYNIC-TOC scintigraphy for evaluation of lung lesions in patients with neuroendocrine tumors (NETs). Single photon emission computed tomography (SPECT) of the thorax and whole body scintigraphy were performed in 34 patients using Tc-EDDA/HYNIC-TOC. Visual assessment was complemented by semiquantitative evaluation based on tumor to non-tumor (T/NT) ratio. Clinical, laboratory, and histological findings served as the standard for comparison. Enhanced tracer uptake was observed on both SPECT and whole body scintigraphy in 29 of 34 patients (88% sensitivity). T/NT ratios were significantly higher on SPECT than whole body images (2.96±1.07 vs.1.70±0.43, p<0.01) and did not correlate with NET proliferation index p=0.27). Conclusion: 99m Tc-EDDA/ HYNIC-TOC scintigraphy is useful for evaluation of NET tissue in the lungs. SPECT provides better visualization of lung lesions than whole body scintigraphy. The intensity of tracer uptake, however, does not relate to the proliferation rate of NETs. Tc-EDDA/HYNIC-TOC scintigraphy may be helpful for selecting and monitoring treatment options, particularly when radiolabeled somatostatin analogue therapy becomes available.

Evaluation of neuroendocrine tumors with 99mTc-EDDA/HYNIC TOC

“…Our previous results in lung lesions [5,6] showed Original 87-88% sensitivity, 84-85% specificity, and 86-88% accuracy. This investigation has been reported to be usefull method for the detection of NET of different origin and localization, the results were similar to those obtained with 111…”

Predictive Value of 99MTC-hynic-toc Scintigraphy in Lung Neuroendocrine Tumor Diagnosis

“…This radiopeptide had encouraging preclinical data: high binding affinity to SST2, high internalization capability to SST2 + cells, high specific uptake in SST2 + tumors AR4-2J, and low uptake in the kidneys. 18,19…”

“…This radiopeptide had encouraging preclinical data: high binding affinity to SST2, high internalization capability to SST2 þ cells, high specific uptake in SST2 þ tumors AR4-2J, and low uptake in the kidneys. 18,19 However, to date, only few studies evaluated the Tc-99m-EDDA/HYNIC-TOC scintigraphy use in the diagnosis of Lu-NETs. [20][21][22] A vital need still unmet for these tumors is a clinically applicable biomarker development that captures NET behavior and can be introduced to guide clinical therapeutic schemes.…”

Contemporary nuclear medicine diagnostics of neuroendocrine tumors

“…У на шој зе мљи су у ру тин ској упо тре би углав ном кон вен ци о нал не ме то де, ко је под ра зу ме ва ју ко ри шћење га ма-сцин ти ла ци о не ка ме ре за ви зу е ли за ци ју неу ро ен до кри них ту мо ра [5], али и за ка рак те ри за ци ју пул мо нал них ле зи ја [6,7].…”