Influence of tumour size and uptake of 99mTc-octreotide on radio-guided surgery for neuroendocrine tumors.

Abstract

AIM:

The aim of this study was to analyze the influence of scintigraphic uptake grade and tumour size on radio-guided surgery of neuroendocrine tumours (NETs) using 99mTc-EDDA/HYNIC-TOC (99mTc-octreotide).

METHODS:

We investigated 21 patients with NET (F=8, M=13) for localization of 27 known lesions using a gamma probe. Three to 6 hours before surgery, 550-650 MBq of 99mTc-octreotide was injected followed by immediate imaging prior to surgery. The uptake was graded on a scale from 0-4. Localization was confirmed by endoscopic ultrasound (EUS), computed tomography (CT) and/or magnetic resonance imaging (MRI). Morphological images were used to determine size of the lesion. Local measurements of radioactivity were performed during surgery using a gamma probe.

RESULTS:

Twenty lesions were successfully localized intraoperatively using a gamma probe (7=grade 4, 9=grade 3, 2=grade 2 and 2=grade 0). The size of successfully localized lesions ranged between 9 and 50 mm. Seven lesions were not localized successfully of which 6 were seen on scintigraphy (2=grade 4, 1=grade 3 and 3=grade 2). The 7th lesion was not seen on preoperative scintigraphy and not localized successfully. The size of unsuccessfully localized lesions ranged between 7 and 30 mm.

CONCLUSIONS:

High octreotide uptake (grade 3 and 4) influence radioguided surgery. Tumour size did not influence the success of localization of lesions by gamma probe.

• Authors: M Hodolic, J Fettich, D Rubello
• Journal: Minerva endocrinologica (Minerva Endocrinol) Vol. 34 Issue 2 Pg. 89-96 (Jun 2009) ISSN: 0391-1977 [Print] Italy
• PMID: 19471233 (Publication Type: Journal Article)

Chemical References

• 99mTc-octreotide
• Organotechnetium Compounds
• Radiopharmaceuticals
• Octreotide

Topics

• Adult
• Aged
• Female
• Follow-Up Studies
• Humans
• Image Enhancement
• Male
• Medical Records
• Middle Aged
• Neoplasm Staging
• Neuroendocrine Tumors (diagnostic imaging, pathology, surgery)
• Octreotide (analogs & derivatives)
• Organotechnetium Compounds
• Radionuclide Imaging
• Radiopharmaceuticals
• Reproducibility of Results
• Retrospective Studies
• Sensitivity and Specificity
• Surgery, Computer-Assisted
• Treatment Outcome