Somatostatin receptor scintigraphy with 111In-octreotide in pulmonary carcinoid tumours correlated with pathological and 18FDG PET/CT findings. 2012

Serkan Kuyumcu, and Isik Adalet, and Yasemin Sanli, and Cuneyt Turkmen, and Zeynep Gozde Ozkan, and Dilek Yilmazbayhan
Department of Nuclear Medicine, Istanbul Medical Faculty, Istanbul University, 34390, Fatih, Istanbul, Turkey. srkuyumcu@gmail.com

OBJECTIVE Pulmonary carcinoid (PC) tumors are rare neoplasms of the lung with good prognosis but diagnosis may be demanding since there is no exclusive modality alone to clearly differentiate a PC tumor. The purpose of this study is to establish the diagnostic features of somatostatin receptor scintigraphy (SRS), comparatively (where available) with 18FDG PET/CT (PET/CT) correlated with histopathologic findings. METHODS Twenty-one patients who underwent SRS with 111In-octreotide and were diagnosed as having PC tumors were retrospectively studied. Thirteen patients were performed PET/CT. Primary tumour size, Ki-67 indexes, image analysis data of SRS and PET/CT including maximum standardized uptake values (SUVmax) together with false negative, false positive, true positive and true negative lesions were documented and discussed. RESULTS Eleven (52.4%) patients were typical (TC) and 10 (47.6%) were atypical carcinoids (AC) with mean Ki-67 indexes of 2.1 and 24%, respectively. Patients underwent SRS for solitary pulmonary nodule (SPN) characterization (n = 12) and determination of disease extension (n = 9). Overall sensitivity and specificity of SRS in the detection of primary tumour, lymph nodes (LN) and distant metastasis (DM) were 76 and 97 %, respectively, whereas, positive and negative predictive values were 95 and 86 %. PET/CT was performed for determining disease spread (n = 3) and metabolic characterization (n = 10) of SPNs. Mean SUVmax in the primary pulmonary lesion in TCs and ACs were 2.9 ± 0.8 and 7.9 ± 5.4, respectively. Nodal involvement (n = 5) and DM (n = 3) were also detected. Sensitivity and specificity of PET/CT in the detection of primary tumour, LNs and DM were 85 and 89.4 %, respectively. CONCLUSIONS SRS is useful in the diagnosis and monitoring of PC tumors when incorporated with 18FDG PET/CT as a primary staging tool particularly in the determination of disease spread.

UI MeSH Term Description Entries
D008175 Lung Neoplasms Tumors or cancer of the LUNG. Cancer of Lung,Lung Cancer,Pulmonary Cancer,Pulmonary Neoplasms,Cancer of the Lung,Neoplasms, Lung,Neoplasms, Pulmonary,Cancer, Lung,Cancer, Pulmonary,Cancers, Lung,Cancers, Pulmonary,Lung Cancers,Lung Neoplasm,Neoplasm, Lung,Neoplasm, Pulmonary,Pulmonary Cancers,Pulmonary Neoplasm
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009362 Neoplasm Metastasis The transfer of a neoplasm from one organ or part of the body to another remote from the primary site. Metastase,Metastasis,Metastases, Neoplasm,Metastasis, Neoplasm,Neoplasm Metastases,Metastases
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D002276 Carcinoid Tumor A usually small, slow-growing neoplasm composed of islands of rounded, oxyphilic, or spindle-shaped cells of medium size, with moderately small vesicular nuclei, and covered by intact mucosa with a yellow cut surface. The tumor can occur anywhere in the gastrointestinal tract (and in the lungs and other sites); approximately 90% arise in the appendix. It is now established that these tumors are of neuroendocrine origin and derive from a primitive stem cell. (From Stedman, 25th ed & Holland et al., Cancer Medicine, 3d ed, p1182) Argentaffinoma,Carcinoid,Carcinoid, Goblet Cell,Argentaffinomas,Carcinoid Tumors,Carcinoids,Carcinoids, Goblet Cell,Goblet Cell Carcinoid,Goblet Cell Carcinoids,Tumor, Carcinoid,Tumors, Carcinoid
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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