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Erschienen in: Annals of Nuclear Medicine 3/2018

01.04.2018 | Original Article

The influence of elevated hormone levels on physiologic accumulation of 68Ga-DOTATOC

verfasst von: Masao Watanabe, Yuji Nakamoto, Sho Koyasu, Takayoshi Ishimori, Akihiro Yasoda, Kaori Togashi

Erschienen in: Annals of Nuclear Medicine | Ausgabe 3/2018

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Abstract

Objective

PET/CT imaging with 68Ga-1,4,7,10-tetraazacyclododecane-N,N′,N″,N‴-tetraacetic acid-D-Phe1-Tyr3-octreotide (DOTATOC) is useful in patients with neuroendocrine tumors (NETs). Functioning NETs by definition secrete abnormal levels of hormones, causing clinical symptoms. It is known that physiologic accumulation can be seen in some organs, but it remains unknown whether elevated hormone levels can affect the physiologic accumulation pattern of 68Ga-DOTATOC. We aimed to investigate the influence of higher hormone levels on physiologic accumulation of 68Ga-DOTATOC.

Methods

A total of 167 patients with known or suspected NET lesions were enrolled in this study. The numbers of patients with elevations of ACTH, gastrin, insulin, and no elevation were 10, 25, 7, and 125, respectively. We compared the maximum standardized uptake value (SUVmax) in various organs of each group.

Results

In the group with elevated ACTH levels, SUVmax in the pituitary gland, the uncinate process of the pancreas and adrenal glands was lower than those in the group with no elevation (5.7 ± 1.9 vs. 8.4 ± 3.1, P = 0.015; 4.7 ± 3.5 vs. 6.4 ± 2.8, P = 0.037; 10.8 ± 4.8 vs. 13.9 ± 4.7, P = 0.020, respectively). There were no differences in physiologic uptake of 68Ga-DOTATOC in the thyroid gland, the pancreatic body, the liver, the spleen, the bowel, or the kidney.

Conclusions

In NET patients with elevated ACTH levels, physiologic uptake of 68Ga-DOTATOC in the pituitary gland, the uncinate process of the pancreas and adrenal glands was significantly decreased. Other organs were unaffected.
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Literatur
1.
Zurück zum Zitat Ambrosini V, Fani M, Fanti S, Forrer F, Maecke HR. Radiopeptide imaging and therapy in Europe. J Nucl Med. 2011;52(Suppl 2):42–55.CrossRef Ambrosini V, Fani M, Fanti S, Forrer F, Maecke HR. Radiopeptide imaging and therapy in Europe. J Nucl Med. 2011;52(Suppl 2):42–55.CrossRef
2.
Zurück zum Zitat Naswa N, Sharma P, Soundararajan R, Karunanithi S, Nazar AH, Kumar R, et al. Diagnostic performance of somatostatin receptor PET/CT using 68 Ga-DOTANOC in gastrinoma patients with negative or equivocal CT findings. Abdom Imaging. 2013;38:552–60.CrossRefPubMed Naswa N, Sharma P, Soundararajan R, Karunanithi S, Nazar AH, Kumar R, et al. Diagnostic performance of somatostatin receptor PET/CT using 68 Ga-DOTANOC in gastrinoma patients with negative or equivocal CT findings. Abdom Imaging. 2013;38:552–60.CrossRefPubMed
3.
Zurück zum Zitat Van Binnebeek S, Vanbilloen B, Baete K, Terwinghe C, Koole M, Mottaghy FM, et al. Comparison of diagnostic accuracy of 111In-pentetreotide SPECT and 68Ga-DOTATOC PET/CT: a lesion-by-lesion analysis in patients with metastatic neuroendocrine tumours. Eur Radiol. 2016;26:900–9.CrossRefPubMed Van Binnebeek S, Vanbilloen B, Baete K, Terwinghe C, Koole M, Mottaghy FM, et al. Comparison of diagnostic accuracy of 111In-pentetreotide SPECT and 68Ga-DOTATOC PET/CT: a lesion-by-lesion analysis in patients with metastatic neuroendocrine tumours. Eur Radiol. 2016;26:900–9.CrossRefPubMed
4.
Zurück zum Zitat Jacobsson H, Larsson P, Jonsson C, Jussing E, Grybäck P. Normal uptake of 68 Ga-DOTA-TOC by the pancreas uncinate process mimicking malignancy at somatostatin receptor PET. Clin Nucl Med. 2012;37:362–5.CrossRefPubMed Jacobsson H, Larsson P, Jonsson C, Jussing E, Grybäck P. Normal uptake of 68 Ga-DOTA-TOC by the pancreas uncinate process mimicking malignancy at somatostatin receptor PET. Clin Nucl Med. 2012;37:362–5.CrossRefPubMed
5.
Zurück zum Zitat Kroiss A, Putzer D, Decristoforo C, Uprimny C, Warwitz B, Nilica B, et al. 68 Ga-DOTA-TOC uptake in neuroendocrine tumour and healthy tissue: differentiation of physiological uptake and pathological processes in PET/CT. Eur J Nucl Med Mol Imaging. 2013;40:514–23.CrossRefPubMed Kroiss A, Putzer D, Decristoforo C, Uprimny C, Warwitz B, Nilica B, et al. 68 Ga-DOTA-TOC uptake in neuroendocrine tumour and healthy tissue: differentiation of physiological uptake and pathological processes in PET/CT. Eur J Nucl Med Mol Imaging. 2013;40:514–23.CrossRefPubMed
6.
Zurück zum Zitat Al-Ibraheem A, Bundschuh RA, Notni J, Buck A, Winter A, Wester HJ, et al. Focal uptake of 68 Ga-DOTATOC in the pancreas: pathological or physiological correlate in patients with neuroendocrine tumours? Eur J Nucl Med Mol Imaging. 2011;38:2005–13.CrossRefPubMed Al-Ibraheem A, Bundschuh RA, Notni J, Buck A, Winter A, Wester HJ, et al. Focal uptake of 68 Ga-DOTATOC in the pancreas: pathological or physiological correlate in patients with neuroendocrine tumours? Eur J Nucl Med Mol Imaging. 2011;38:2005–13.CrossRefPubMed
7.
Zurück zum Zitat Imamura M, Nakamoto Y, Uose S, Komoto I, Awane M, Taki Y. Diagnosis of functioning pancreaticoduodenal neuroendocrine tumors. J Hepatobiliary Pancreat Sci. 2015;22:602–9.CrossRefPubMed Imamura M, Nakamoto Y, Uose S, Komoto I, Awane M, Taki Y. Diagnosis of functioning pancreaticoduodenal neuroendocrine tumors. J Hepatobiliary Pancreat Sci. 2015;22:602–9.CrossRefPubMed
8.
Zurück zum Zitat Nakamoto Y, Sano K, Ishimori T, Ueda M, Temma T, Saji H, et al. Additional information gained by positron emission tomography with 68Ga-DOTATOC for suspected unknown primary or recurrent neuroendocrine tumors. Ann Nucl Med. 2015;29:512–8.CrossRefPubMedPubMedCentral Nakamoto Y, Sano K, Ishimori T, Ueda M, Temma T, Saji H, et al. Additional information gained by positron emission tomography with 68Ga-DOTATOC for suspected unknown primary or recurrent neuroendocrine tumors. Ann Nucl Med. 2015;29:512–8.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Kaemmerer D, Peter L, Lupp A, Schulz S, Sänger J, Prasad V, et al. Molecular imaging with 68Ga-SSTR PET/CT and correlation to immunohistochemistry of somatostatin receptors in neuroendocrine tumours. Eur J Nucl Med Mol Imaging. 2011;38:1659–68.CrossRefPubMed Kaemmerer D, Peter L, Lupp A, Schulz S, Sänger J, Prasad V, et al. Molecular imaging with 68Ga-SSTR PET/CT and correlation to immunohistochemistry of somatostatin receptors in neuroendocrine tumours. Eur J Nucl Med Mol Imaging. 2011;38:1659–68.CrossRefPubMed
10.
Zurück zum Zitat Miederer M, Seidl S, Buck A, Scheidhauer K, Wester HJ, Schwaiger M, et al. Correlation of immunohistopathological expression of somatostatin receptor 2 with standardised uptake values in 68 Ga-DOTATOC PET/CT. Eur J Nucl Med Mol Imaging. 2009;36:48–52.CrossRefPubMed Miederer M, Seidl S, Buck A, Scheidhauer K, Wester HJ, Schwaiger M, et al. Correlation of immunohistopathological expression of somatostatin receptor 2 with standardised uptake values in 68 Ga-DOTATOC PET/CT. Eur J Nucl Med Mol Imaging. 2009;36:48–52.CrossRefPubMed
11.
Zurück zum Zitat Boy C, Heusner TA, Poeppel TD, Redmann-Bischofs A, Unger N, Jentzen W, et al. 68 Ga-DOTATOC PET/CT and somatostatin receptor (sst1–sst5) expression in normal human tissue: correlation of sst2 mRNA and SUVmax. Eur J Nucl Med Mol Imaging. 2011;38:1224–36.CrossRefPubMed Boy C, Heusner TA, Poeppel TD, Redmann-Bischofs A, Unger N, Jentzen W, et al. 68 Ga-DOTATOC PET/CT and somatostatin receptor (sst1–sst5) expression in normal human tissue: correlation of sst2 mRNA and SUVmax. Eur J Nucl Med Mol Imaging. 2011;38:1224–36.CrossRefPubMed
12.
Zurück zum Zitat Gallo-Payet N. 60 years of POMC: adrenal and extra-adrenal functions of ACTH. J Mol Endocrinol. 2016;56:135–56.CrossRef Gallo-Payet N. 60 years of POMC: adrenal and extra-adrenal functions of ACTH. J Mol Endocrinol. 2016;56:135–56.CrossRef
13.
Zurück zum Zitat Park S, Kamegai J, Kineman RD. Role of glucocorticoids in the regulation of pituitary somatostatin receptor subtype (sst1-sst5) mRNA levels: evidence for direct and somatostatin-mediated effects. Neuroendocrinology. 2003;78:163–75.CrossRefPubMed Park S, Kamegai J, Kineman RD. Role of glucocorticoids in the regulation of pituitary somatostatin receptor subtype (sst1-sst5) mRNA levels: evidence for direct and somatostatin-mediated effects. Neuroendocrinology. 2003;78:163–75.CrossRefPubMed
14.
Zurück zum Zitat Hofland LJ, Lamberts SW, Feelders RA. Role of somatostatin receptors in normal and tumoral pituitary corticotropic cells. Neuroendocrinology. 2010;92(Suppl 1):11–6.CrossRefPubMed Hofland LJ, Lamberts SW, Feelders RA. Role of somatostatin receptors in normal and tumoral pituitary corticotropic cells. Neuroendocrinology. 2010;92(Suppl 1):11–6.CrossRefPubMed
15.
Zurück zum Zitat Eigler T, Ben-Shlomo A. Somatostatin system: molecular mechanisms regulating anterior pituitary hormones. J Mol Endocrinol. 2014;53:1–19.CrossRef Eigler T, Ben-Shlomo A. Somatostatin system: molecular mechanisms regulating anterior pituitary hormones. J Mol Endocrinol. 2014;53:1–19.CrossRef
16.
Zurück zum Zitat van der Hoek J, Waaijers M, van Koetsveld PM, Sprij-Mooij D, Feelders RA, Schmid HA, et al. Distinct functional properties of native somatostatin receptor subtype 5 compared with subtype 2 in the regulation of ACTH release by corticotroph tumor cells. Am J Physiol Endocrinol Metab. 2005;289:278–87.CrossRef van der Hoek J, Waaijers M, van Koetsveld PM, Sprij-Mooij D, Feelders RA, Schmid HA, et al. Distinct functional properties of native somatostatin receptor subtype 5 compared with subtype 2 in the regulation of ACTH release by corticotroph tumor cells. Am J Physiol Endocrinol Metab. 2005;289:278–87.CrossRef
17.
Zurück zum Zitat Xu Y, Berelowitz M, Bruno JF. Dexamethasone regulates somatostatin receptor subtype messenger ribonucleic acid expression in rat pituitary GH4C1 cells. Endocrinology. 1995;136:5070–5.CrossRefPubMed Xu Y, Berelowitz M, Bruno JF. Dexamethasone regulates somatostatin receptor subtype messenger ribonucleic acid expression in rat pituitary GH4C1 cells. Endocrinology. 1995;136:5070–5.CrossRefPubMed
18.
Zurück zum Zitat Kraus J, Wöltje M, Höllt V. Regulation of mouse somatostatin receptor type 2 gene expression by glucocorticoids. FEBS Lett. 1999;459:200–4.CrossRefPubMed Kraus J, Wöltje M, Höllt V. Regulation of mouse somatostatin receptor type 2 gene expression by glucocorticoids. FEBS Lett. 1999;459:200–4.CrossRefPubMed
19.
Zurück zum Zitat Kraus J, Wöltje M, Schönwetter N, Höllt V. Alternative promoter usage and tissue specific expression of the mouse somatostatin receptor 2 gene. FEBS Lett. 1998;428:165–70.CrossRefPubMed Kraus J, Wöltje M, Schönwetter N, Höllt V. Alternative promoter usage and tissue specific expression of the mouse somatostatin receptor 2 gene. FEBS Lett. 1998;428:165–70.CrossRefPubMed
Metadaten
Titel
The influence of elevated hormone levels on physiologic accumulation of 68Ga-DOTATOC
verfasst von
Masao Watanabe
Yuji Nakamoto
Sho Koyasu
Takayoshi Ishimori
Akihiro Yasoda
Kaori Togashi
Publikationsdatum
01.04.2018
Verlag
Springer Japan
Erschienen in
Annals of Nuclear Medicine / Ausgabe 3/2018
Print ISSN: 0914-7187
Elektronische ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-018-1233-4

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