Our aim was to evaluate the different clinical value of (111)In-pentetreotide hybrid SPET/CT versus SPET alone in detecting carcinoid tumours located in the thoracic and abdominal region. Twenty-four patients with carcinoid tumours histologically proven (13 of abdominal origin, 11 of thoracic origin) underwent (111)In-pentetreotide SPET/CT with hybrid system (Millennium VG with Hawkeye, G.E.M.S., USA) composed of a dual head gamma camera equipped with a low dose X-ray tube. Single photon emission tomography images were performed 4h and 24h after (111)In-pentetreotide intravenous administration, while SPET/CT co-registered images were performed at 4h. Scintigraphic images were first evaluated alone and then re-interpreted by adding transmission fused data. Nine of the 13 patients with tumours of abdominal origin showed pathological SPET images, while 4/13 were negative. Seven out of the 11 patients with tumour of thoracic origin had pathological SPET findings, while 4/11 were negative. In all, 11/24 subjects disclosed abdominal pathological uptake and 10/24 thoracic. In 6/11 abdominal cases SPET/CT allowed anatomical localization of lesions, while in 2/10 in thoracic cases. Additional data were provided by SPET/CT in 8/24 cases (6 abdominal, 2 thoracic), by transmission images characterized as lesions not expressing somatostatin receptors. Sensitivity of SPET alone in all carcinoids was 72%, negative predictive value (NPV) was 50% and accuracy was 78%. Considering abdominal lesions (independently of the origin) sensitivity of SPET alone was 64.7%, NPV was 40%, accuracy was 71.4%. For thoracic lesions sensitivity of SPET alone was 83.3%, NPV was 66.7% and accuracy was 87.5%. For SPET/CT considering together all carcinoids and also separately lesions of abdominal and of thoracic origin, sensitivity, NPV and accuracy were always 100%. In conclusion, SPET/CT imaging was more useful to anatomically detect carcinoids either in abdomen or in thorax and specifically lesions not expressing somatostatin receptors, as compared to SPET alone.
(111)In-pentetreotide SPET/CT in carcinoid tumours: is the role of hybrid systems advantageous in abdominal or thoracic lesions?
TRANFAGLIA, CRISTINA;CARDINALI, LAURA;GATTUCCI, MAURIZIO;SCIALPI, Michele;FEROLLA, PIERO;PALUMBO, Barbara
2011
Abstract
Our aim was to evaluate the different clinical value of (111)In-pentetreotide hybrid SPET/CT versus SPET alone in detecting carcinoid tumours located in the thoracic and abdominal region. Twenty-four patients with carcinoid tumours histologically proven (13 of abdominal origin, 11 of thoracic origin) underwent (111)In-pentetreotide SPET/CT with hybrid system (Millennium VG with Hawkeye, G.E.M.S., USA) composed of a dual head gamma camera equipped with a low dose X-ray tube. Single photon emission tomography images were performed 4h and 24h after (111)In-pentetreotide intravenous administration, while SPET/CT co-registered images were performed at 4h. Scintigraphic images were first evaluated alone and then re-interpreted by adding transmission fused data. Nine of the 13 patients with tumours of abdominal origin showed pathological SPET images, while 4/13 were negative. Seven out of the 11 patients with tumour of thoracic origin had pathological SPET findings, while 4/11 were negative. In all, 11/24 subjects disclosed abdominal pathological uptake and 10/24 thoracic. In 6/11 abdominal cases SPET/CT allowed anatomical localization of lesions, while in 2/10 in thoracic cases. Additional data were provided by SPET/CT in 8/24 cases (6 abdominal, 2 thoracic), by transmission images characterized as lesions not expressing somatostatin receptors. Sensitivity of SPET alone in all carcinoids was 72%, negative predictive value (NPV) was 50% and accuracy was 78%. Considering abdominal lesions (independently of the origin) sensitivity of SPET alone was 64.7%, NPV was 40%, accuracy was 71.4%. For thoracic lesions sensitivity of SPET alone was 83.3%, NPV was 66.7% and accuracy was 87.5%. For SPET/CT considering together all carcinoids and also separately lesions of abdominal and of thoracic origin, sensitivity, NPV and accuracy were always 100%. In conclusion, SPET/CT imaging was more useful to anatomically detect carcinoids either in abdomen or in thorax and specifically lesions not expressing somatostatin receptors, as compared to SPET alone.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
