Document Detail

Limited value of fluorine-18 fluorodeoxyglucose positron emission tomography for the imaging of neuroendocrine tumours.
MedLine Citation:
PMID:  9396878     Owner:  NLM     Status:  MEDLINE    
Scintigraphy using [111In-DTPA-d-Phe1]-pentetreotide or pentavalent technetium-99m-dimercaptosuccinic acid [99mTc(V)-DMSA] has been shown to localize well-differentiated and slowly growing neuroendocrine tumours, whereas increased fluorodeoxyglucose (FDG) uptake is associated with malignancy. The aim of this study was to compare the value of fluorine-18 FDG positron emission tomography (PET) with that of somatostatin receptor scintigraphy (SS-R) and dual-radionuclide scintigraphy [SS-R and 99mTc(V)-DMSA = DNS] in detecting malignant neuroendocrine tumours. Fifteen patients with metastasizing gastroenteropancreatic tumours (GEP tumours; n = 7), medullary thyroid carcinomas (MTCs; n = 8) and elevated tumour markers [GEP tumours: 5-hydroxyindoleacetic acid, insulin; MTCs: calcitonin, carcinoembryonic antigen (CEA)] were studied. Prior to PET, all patients with GEP tumours underwent SS-R. DNS was performed in all patients with MTC. Patients had been fasting for at least 12 h and normal glucose plasma levels were confirmed. Sixty minutes after intravenous administration of 18F-FDG (mean: 374 MBq) whole-body PET and regional scans were performed. In addition, the resected tissues were prepared for immunocytochemistry examination (cell cycle-associated Ki-67 antigen). In two patients with less-differentiated GEP tumours associated with high proliferative activity and increased FDG uptake, SS-R failed to detect any lesion. In comparison, in four patients with well-differentiated GEP tumours showing low proliferative activity, SS-R localized four primary tumours, 22 lymph node metastases and 18 malignant liver lesions, whereas 18F-FDG PET demonstrated normal distribution. In one patient with a metastasizing carcinoid (medium proliferative activity) SS-R localized multiple metastases, whereas PET demonstrated low FDG uptake in all known metastases. In patients with recurrent MTC and rapidly increasing CEA levels DNS detected only three lesions in two patients, whereas PET demonstrated one pulmonary, three osseous, 20 mediastinal, ten locoregional, and four liver metastases in seven patients. Twenty-nine malignant lesions were confirmed by follow-up and nine lymph node metastases could be surgically removed. In conclusion, PET imaging of gastroenteropancreatic tumours revealed increased glucose metabolism only in less-differentiated GEP tumours with high proliferative activity and metastasizing MTC associated with rapidly increasing CEA levels. Therefore, additional 18F-FDG PET should be performed only if SS-R or DNS is negative.
S Adams; R Baum; T Rink; P M Schumm-Dräger; K H Usadel; G Hör
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  European journal of nuclear medicine     Volume:  25     ISSN:  0340-6997     ISO Abbreviation:  Eur J Nucl Med     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-03-05     Completed Date:  1998-03-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7606882     Medline TA:  Eur J Nucl Med     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  79-83     Citation Subset:  IM    
Department of Nuclear Medicine, University Medical Center, Frankfurt/Main, Germany.
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MeSH Terms
Fluorodeoxyglucose F18 / diagnostic use*
Gastrointestinal Agents / diagnostic use
Image Processing, Computer-Assisted
Middle Aged
Neuroendocrine Tumors / radionuclide imaging*
Octreotide / diagnostic use
Pancreatic Neoplasms / radionuclide imaging
Pentetic Acid / diagnostic use
Radiopharmaceuticals / diagnostic use*
Stomach Neoplasms / radionuclide imaging
Technetium Tc 99m Dimercaptosuccinic Acid / diagnostic use
Thyroid Neoplasms / radionuclide imaging
Tomography, Emission-Computed
Reg. No./Substance:
0/Gastrointestinal Agents; 0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18; 65438-08-6/Technetium Tc 99m Dimercaptosuccinic Acid; 67-43-6/Pentetic Acid; 83150-76-9/Octreotide

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