Skip to main content
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 11/2006

01.11.2006 | Original article

Improved tumour detection by gastrin receptor scintigraphy in patients with metastasised medullary thyroid carcinoma

verfasst von: Martin Gotthardt, Martin P. Béhé, Daniela Beuter, Anke Battmann, Artur Bauhofer, Tino Schurrat, Meike Schipper, Halina Pollum, Wim J. G. Oyen, Thomas M. Behr

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 11/2006

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Radiopeptide imaging is a valuable imaging method in the management of patients with neuroendocrine tumours (NET). To determine the clinical performance of gastrin receptor scintigraphy (GRS), it was compared with somatostatin receptor scintigraphy (SRS), computed tomography (CT) and 18F-FDG positron emission tomography (PET) in patients with metastasised/recurrent medullary thyroid carcinoma (MTC).

Methods

Twenty-seven consecutive patients underwent imaging with GRS, SRS (19 patients), CT and PET (26 patients). GRS and SRS were compared with respect to tumour detection and uptake. CT, PET, magnetic resonance imaging (MRI), ultrasound (US) and follow-up were used for verification of findings. In addition, GRS, CT and PET were directly compared with each other to determine which method performs best.

Results

Nineteen patients underwent both GRS and SRS. Among these, GRS showed a tumour detection rate of 94.2% as compared to 40.7% for SRS [mean number of tumour sites (±SD) and 95% confidence intervals (CI): GRS 4.3±3.1/2.8–5.7, SRS 1.8±1.6/1.1–2.6]. In 26 patients, GRS, CT and PET were compared. Here, GRS showed a tumour detection rate of 87.3% (CT 76.1%, PET 67.2%; mean number of tumour sites and 95% CI: GRS 4.5±4.0/2.9–6.1, CT 3.9±3.5/2.5–5.3, PET 3.5±3.3/2.1–4.8). If GRS and CT were combined, they were able to detect 96.7% of areas of tumour involvement.

Conclusion

GRS had a higher tumour detection rate than SRS and PET in our study. GRS in combination with CT was most effective in the detection of metastatic MTC.
Literatur
1.
Zurück zum Zitat Krenning EP, Kwekkeboom DJ, Bakker WH, Breeman WA, Kooij PP, Oei HY, et al. Somatostatin receptor scintigraphy with (111In-DTPA-D-Phe1)- and (123I-Tyr3)-octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med 1993;20:716–731PubMedCrossRef Krenning EP, Kwekkeboom DJ, Bakker WH, Breeman WA, Kooij PP, Oei HY, et al. Somatostatin receptor scintigraphy with (111In-DTPA-D-Phe1)- and (123I-Tyr3)-octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med 1993;20:716–731PubMedCrossRef
2.
Zurück zum Zitat Modlin IM, Tang LH. Approaches to the diagnosis of gut neuroendocrine tumours: the last word today. Gastroenterology 1997;112:583–590PubMedCrossRef Modlin IM, Tang LH. Approaches to the diagnosis of gut neuroendocrine tumours: the last word today. Gastroenterology 1997;112:583–590PubMedCrossRef
3.
Zurück zum Zitat Ricke J, Klose KJ, Mignon M, Öberg K, Wiedenmann B. Standardisation of imaging in neuroendocrine tumours: results of a European Delphi process. Eur J Radiol 2001;37:8–17PubMedCrossRef Ricke J, Klose KJ, Mignon M, Öberg K, Wiedenmann B. Standardisation of imaging in neuroendocrine tumours: results of a European Delphi process. Eur J Radiol 2001;37:8–17PubMedCrossRef
4.
Zurück zum Zitat Lamberts SW, Bakker WH, Reubi JC, Krenning EP. Somatostatin-receptor imaging in the localization of endocrine tumours. N Engl J Med 1990;323:1246–1249PubMedCrossRef Lamberts SW, Bakker WH, Reubi JC, Krenning EP. Somatostatin-receptor imaging in the localization of endocrine tumours. N Engl J Med 1990;323:1246–1249PubMedCrossRef
5.
Zurück zum Zitat Bakker WH, Krenning EP, Reubi JC, Breeman WA, Setyono-Han B, de Jong M, et al. In vivo application of [111In-DTPA-D-Phe1]-octreotide for detection of somatostatin receptor-positive tumours in rats. Life Sci 1991;49:1593–1601PubMedCrossRef Bakker WH, Krenning EP, Reubi JC, Breeman WA, Setyono-Han B, de Jong M, et al. In vivo application of [111In-DTPA-D-Phe1]-octreotide for detection of somatostatin receptor-positive tumours in rats. Life Sci 1991;49:1593–1601PubMedCrossRef
6.
Zurück zum Zitat Termanini B, Gibril F, Reynolds JC, Dopman JL, chen CC, Stewart CA, et al. Value of somatostatin receptor scintigraphy: a prospective study in gastrinoma of its effect on clinical management. Gastroenterology 1997;112:335–347PubMedCrossRef Termanini B, Gibril F, Reynolds JC, Dopman JL, chen CC, Stewart CA, et al. Value of somatostatin receptor scintigraphy: a prospective study in gastrinoma of its effect on clinical management. Gastroenterology 1997;112:335–347PubMedCrossRef
7.
Zurück zum Zitat Lebtahi R, Cadiot G, Sarda L, Daou D, Faraggi M, Petegnief Y, et al. Clinical impact of somatostatin receptor scintigraphy in the management of patients with neuroendocrine gastroenteropancreatic tumours. J Nucl Med 1997;38:853–858PubMed Lebtahi R, Cadiot G, Sarda L, Daou D, Faraggi M, Petegnief Y, et al. Clinical impact of somatostatin receptor scintigraphy in the management of patients with neuroendocrine gastroenteropancreatic tumours. J Nucl Med 1997;38:853–858PubMed
8.
Zurück zum Zitat Behr TM, Gratz S, Markus PM, Dunn RM, Hufner M, Schauer A, et al. Anti-carcinoembryonic antigen antibodies versus somatostatin analogs in the detection of metastatic medullary thyroid carcinoma: are carcinoembryonic antigen and somatostatin receptor expression prognostic factors? Cancer 1997;80:2436–2457PubMedCrossRef Behr TM, Gratz S, Markus PM, Dunn RM, Hufner M, Schauer A, et al. Anti-carcinoembryonic antigen antibodies versus somatostatin analogs in the detection of metastatic medullary thyroid carcinoma: are carcinoembryonic antigen and somatostatin receptor expression prognostic factors? Cancer 1997;80:2436–2457PubMedCrossRef
9.
Zurück zum Zitat Diehl M, Risse JH, Brandt-Mainz K, Dietlein M, Bohuslavizki KH, Matheja P, et al. Fluorine-18 fluorodeoxyglucose positron emission tomography in medullary thyroid cancer: results of a multicentre study. Eur J Nucl Med 2001;28:1671–1676PubMedCrossRef Diehl M, Risse JH, Brandt-Mainz K, Dietlein M, Bohuslavizki KH, Matheja P, et al. Fluorine-18 fluorodeoxyglucose positron emission tomography in medullary thyroid cancer: results of a multicentre study. Eur J Nucl Med 2001;28:1671–1676PubMedCrossRef
10.
Zurück zum Zitat Szakáll S, Ésik O, Bajzik G, Repa I, Dabasi G, Sinkovics I, et al.18F-FDG PET detection of lymph node metastases in medullary thyroid carcinoma. J Nucl Med 2002;43:66–71PubMed Szakáll S, Ésik O, Bajzik G, Repa I, Dabasi G, Sinkovics I, et al.18F-FDG PET detection of lymph node metastases in medullary thyroid carcinoma. J Nucl Med 2002;43:66–71PubMed
11.
Zurück zum Zitat Brandt-Mainz K, Müller SP, Görges R, Saller B, Bokisch A. The value of fluorine-18 fluorodeoxyglucose PET in patients with medullary thyroid cancer. Eur J Nucl Med 2000;27:490–496PubMedCrossRef Brandt-Mainz K, Müller SP, Görges R, Saller B, Bokisch A. The value of fluorine-18 fluorodeoxyglucose PET in patients with medullary thyroid cancer. Eur J Nucl Med 2000;27:490–496PubMedCrossRef
12.
Zurück zum Zitat Högerle S, Altehöfer C, Ghanem N, Brink I, Moser E, Nitzsche E.18F-DOPA positron emission tomography for tumour detection in patients with medullary thyroid carcinoma and elevated calcitonin levels. Eur J Nucl Med 2001;28:64–71CrossRef Högerle S, Altehöfer C, Ghanem N, Brink I, Moser E, Nitzsche E.18F-DOPA positron emission tomography for tumour detection in patients with medullary thyroid carcinoma and elevated calcitonin levels. Eur J Nucl Med 2001;28:64–71CrossRef
13.
Zurück zum Zitat Gotthardt M, Battmann A, Höffken H, Schurrat T, Pollum H, Beuter D, et al. 18F-FDG-PET, somatostatin receptor scintigraphy, and CT in metastatic medullary thyroid carcinoma: a clinical study and an analysis of the literature. Nucl Med Commun 2004;25:439–443PubMedCrossRef Gotthardt M, Battmann A, Höffken H, Schurrat T, Pollum H, Beuter D, et al. 18F-FDG-PET, somatostatin receptor scintigraphy, and CT in metastatic medullary thyroid carcinoma: a clinical study and an analysis of the literature. Nucl Med Commun 2004;25:439–443PubMedCrossRef
14.
Zurück zum Zitat Gimm O, Sutter T, Dralle H. Diagnosis and therapy of sporadic and familial medullary thyroid carcinoma. J Cancer Res Clin Oncol 2001;127:156–165PubMedCrossRef Gimm O, Sutter T, Dralle H. Diagnosis and therapy of sporadic and familial medullary thyroid carcinoma. J Cancer Res Clin Oncol 2001;127:156–165PubMedCrossRef
15.
Zurück zum Zitat Behr TM, Jenner M, Béhé M, Angerstein C, Gratz S, Raue F, et al. Radiolabelled peptides for targeting of cholecystokinin-B/gastrin receptor expressing tumours: from preclinical development to initial clinical results. J Nucl Med 1999;40:1029–1044PubMed Behr TM, Jenner M, Béhé M, Angerstein C, Gratz S, Raue F, et al. Radiolabelled peptides for targeting of cholecystokinin-B/gastrin receptor expressing tumours: from preclinical development to initial clinical results. J Nucl Med 1999;40:1029–1044PubMed
16.
Zurück zum Zitat Juweid M, Sharkey RM, Behr T, Swayne LC, Rubin AD, Herskovic T, et al. Improved detection of medullary thyroid cancer with radiolabelled antibodies to carcinoembryonic antigen. J Clin Oncol 1996;14:1209–1217PubMed Juweid M, Sharkey RM, Behr T, Swayne LC, Rubin AD, Herskovic T, et al. Improved detection of medullary thyroid cancer with radiolabelled antibodies to carcinoembryonic antigen. J Clin Oncol 1996;14:1209–1217PubMed
17.
Zurück zum Zitat Busnardo B, Girelli ME, Simioni N, Nacamulli D, Bosetto E. Nonparallel patterns of calcitonin and carcinoembryonic antigen levels in the follow-up of medullary thyroid carcinoma. Cancer 1984;53:278–285PubMedCrossRef Busnardo B, Girelli ME, Simioni N, Nacamulli D, Bosetto E. Nonparallel patterns of calcitonin and carcinoembryonic antigen levels in the follow-up of medullary thyroid carcinoma. Cancer 1984;53:278–285PubMedCrossRef
18.
Zurück zum Zitat Virgolini I, Raderer M, Kurtaran A, Angelberger P, Banyai S, Yang Q, et al. Vasoactive intestinal peptide-receptor imaging for the localization of intestinal adenocarcinomas and endocrine tumours. N Engl J Med 1994;331:1116–1121PubMedCrossRef Virgolini I, Raderer M, Kurtaran A, Angelberger P, Banyai S, Yang Q, et al. Vasoactive intestinal peptide-receptor imaging for the localization of intestinal adenocarcinomas and endocrine tumours. N Engl J Med 1994;331:1116–1121PubMedCrossRef
19.
Zurück zum Zitat Hessenius C, Bäder M, Meinhold H, Bohmig M, Faiss S, Reubi JC, et al. Vasoactive intestinal peptide receptor scintigraphy in patients with pancreatic adenocarcinomas or neuroendocrine tumours. Eur J Nucl Med 2000;27:1684–1693PubMedCrossRef Hessenius C, Bäder M, Meinhold H, Bohmig M, Faiss S, Reubi JC, et al. Vasoactive intestinal peptide receptor scintigraphy in patients with pancreatic adenocarcinomas or neuroendocrine tumours. Eur J Nucl Med 2000;27:1684–1693PubMedCrossRef
20.
Zurück zum Zitat De Visser M, Janssen PJJM, Srinivasan A, Reubi JC, Waser B, Erion JL, et al. Stabilised 111In-labelled DTPA- and DOTA-conjugated neurotensin analogues for imaging and therapy of exocrine pancreatic cancer. Eur J Nucl Med Mol Imag 2003;30:1134–1139CrossRef De Visser M, Janssen PJJM, Srinivasan A, Reubi JC, Waser B, Erion JL, et al. Stabilised 111In-labelled DTPA- and DOTA-conjugated neurotensin analogues for imaging and therapy of exocrine pancreatic cancer. Eur J Nucl Med Mol Imag 2003;30:1134–1139CrossRef
21.
Zurück zum Zitat Janssen ML, Oyen WJG, Dijkgraaf I, Massuger LF, Frielink C, Edwards DS, et al. Tumor targeting with radiolabelled αvβ3 integrin binding peptides in a nude mouse model. Cancer Res 2002;62:6146–6151PubMed Janssen ML, Oyen WJG, Dijkgraaf I, Massuger LF, Frielink C, Edwards DS, et al. Tumor targeting with radiolabelled αvβ3 integrin binding peptides in a nude mouse model. Cancer Res 2002;62:6146–6151PubMed
22.
Zurück zum Zitat Hennig IM, Laissue JA, Horisberger U, Reubi JC. Substance P receptors in human primary neoplasms. Int J Cancer 1995;61:786–792PubMed Hennig IM, Laissue JA, Horisberger U, Reubi JC. Substance P receptors in human primary neoplasms. Int J Cancer 1995;61:786–792PubMed
23.
Zurück zum Zitat Gotthardt M, Boermann OC, Behr TM, Béhé MP, Oyen WJG. Development and clinical application of peptide-based radiopharmaceuticals. Curr Pharm Design 2004;10:2951–2963CrossRef Gotthardt M, Boermann OC, Behr TM, Béhé MP, Oyen WJG. Development and clinical application of peptide-based radiopharmaceuticals. Curr Pharm Design 2004;10:2951–2963CrossRef
24.
Zurück zum Zitat Reubi JC, Schaer JC, Laissue JA, Waser B. Somatostatin receptors and their subtypes in human tumours and in peritumoural vessels. Metab Clin Exp 1996;45(Suppl 1):39–41PubMed Reubi JC, Schaer JC, Laissue JA, Waser B. Somatostatin receptors and their subtypes in human tumours and in peritumoural vessels. Metab Clin Exp 1996;45(Suppl 1):39–41PubMed
25.
Zurück zum Zitat Sreedharan SP, Kodama KT, Peterson KE, Goetzl EJ. Distinct subsets of somatostatin receptors on cultured human lymphocytes. J Biol Chem 1989;264:949–953PubMed Sreedharan SP, Kodama KT, Peterson KE, Goetzl EJ. Distinct subsets of somatostatin receptors on cultured human lymphocytes. J Biol Chem 1989;264:949–953PubMed
26.
Zurück zum Zitat Blum JE, Handmaker H, Rinne NA. The utility of a somatostatin-type receptor binding peptide radiopharamceutical (P829) in the evaluation of solitary pulmonary nodules. Chest 1999;115:224–232PubMedCrossRef Blum JE, Handmaker H, Rinne NA. The utility of a somatostatin-type receptor binding peptide radiopharamceutical (P829) in the evaluation of solitary pulmonary nodules. Chest 1999;115:224–232PubMedCrossRef
27.
Zurück zum Zitat Stoffel M, Jamar F, Donckier J, Hainaut P, Decoster P, Beckers C, et al. Increased uptake of indium-111 pentetreotide up to 10 years after external thoracic irradiation: report of two cases. Eur J Nucl Med 1996;23:723–726PubMedCrossRef Stoffel M, Jamar F, Donckier J, Hainaut P, Decoster P, Beckers C, et al. Increased uptake of indium-111 pentetreotide up to 10 years after external thoracic irradiation: report of two cases. Eur J Nucl Med 1996;23:723–726PubMedCrossRef
28.
Zurück zum Zitat Verga U, Muratori F, Sacco G, Banfi F, Libroia A. The role of radiopharmaceuticals MIBG and (V)DMSA in the diagnosis of medullary thyroid carcinoma. Henry Ford Hosp Med J 1989;37(3–4):175–177PubMed Verga U, Muratori F, Sacco G, Banfi F, Libroia A. The role of radiopharmaceuticals MIBG and (V)DMSA in the diagnosis of medullary thyroid carcinoma. Henry Ford Hosp Med J 1989;37(3–4):175–177PubMed
29.
Zurück zum Zitat Uğur Ö, Kostakoğlu L, Güler N, Kaner B, Uysal U, Elahi N, et al. Comparison of 99mTc(V)-DMSA. 201Tl, and 99mTc-MIBI imaging in the follow-up of patients with medullary carcinoma of the thyroid. Eur J Nucl Med 1996;23:1367–1371PubMedCrossRef Uğur Ö, Kostakoğlu L, Güler N, Kaner B, Uysal U, Elahi N, et al. Comparison of 99mTc(V)-DMSA. 201Tl, and 99mTc-MIBI imaging in the follow-up of patients with medullary carcinoma of the thyroid. Eur J Nucl Med 1996;23:1367–1371PubMedCrossRef
30.
Zurück zum Zitat Diehl M, Risse JH, Brandt-Mainz K, Dietlein M, Bohuslavitzki KH, Matheja P, et al. Fluorine-\ fluorodeoxyglucose positron emission tomography in medullary thyroid cancer: results of a multicentre study. Eur J Nucl Med 2001;28:1671–1676PubMedCrossRef Diehl M, Risse JH, Brandt-Mainz K, Dietlein M, Bohuslavitzki KH, Matheja P, et al. Fluorine-\ fluorodeoxyglucose positron emission tomography in medullary thyroid cancer: results of a multicentre study. Eur J Nucl Med 2001;28:1671–1676PubMedCrossRef
31.
Zurück zum Zitat Reubi JC, Waser B. Concomitant expression of several peptide receptors in neuroendocrine tumours: molecular basis for in vivo multireceptor imaging. Eur J Nucl Med Mol Imaging 2003;30:781–793PubMedCrossRef Reubi JC, Waser B. Concomitant expression of several peptide receptors in neuroendocrine tumours: molecular basis for in vivo multireceptor imaging. Eur J Nucl Med Mol Imaging 2003;30:781–793PubMedCrossRef
32.
Zurück zum Zitat Béhé M, Kluge W, Becker W, Gotthardt M, Behr TM. Use of polyglutamic acids to reduce uptake of radiometal-labeled minigastrin in the kidneys. J Nucl Med 2005;46:1012–1015PubMed Béhé M, Kluge W, Becker W, Gotthardt M, Behr TM. Use of polyglutamic acids to reduce uptake of radiometal-labeled minigastrin in the kidneys. J Nucl Med 2005;46:1012–1015PubMed
33.
Zurück zum Zitat Maecke HR, Hofmann M, Haberkorn U. 68Ga-labeled peptides in tumor imaging. J Nucl Med 2005;46(Ssuppl 1):172S–178SPubMed Maecke HR, Hofmann M, Haberkorn U. 68Ga-labeled peptides in tumor imaging. J Nucl Med 2005;46(Ssuppl 1):172S–178SPubMed
Metadaten
Titel
Improved tumour detection by gastrin receptor scintigraphy in patients with metastasised medullary thyroid carcinoma
verfasst von
Martin Gotthardt
Martin P. Béhé
Daniela Beuter
Anke Battmann
Artur Bauhofer
Tino Schurrat
Meike Schipper
Halina Pollum
Wim J. G. Oyen
Thomas M. Behr
Publikationsdatum
01.11.2006
Verlag
Springer-Verlag
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 11/2006
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-006-0157-8

Weitere Artikel der Ausgabe 11/2006

European Journal of Nuclear Medicine and Molecular Imaging 11/2006 Zur Ausgabe