背景:目前,使用成像技术诊断唾液腺肿瘤是不可靠的.
方法:在这项单中心回顾性研究中,我们检查了在2010年1月1日至2021年12月31日期间接受68Ga-DOTATOCPET/CT并随后接受唾液腺肿瘤切除术的患者.将PET/CT图像评估与生长抑素受体(SSTR)表达和组织学进行比较。
结果:13例患者(5例多形性腺瘤(PA)和8例其他腮腺病变(OPL))接受了68Ga-DOTATOCPET/CT检查。成像显示所有PA中的局灶性示踪剂摄取都很强,但肿瘤对背景的辨别能力很强。PA显示更高的SUVmax,Suvmean,肝脏和血池商高于Warthin肿瘤(WT)和OPL。与对侧腮腺相比,SUVmax(p=0.02),SUVmean(p=0.02),肝商(p=0.03)和血池商(p=0.03)均显着较高。相比之下,WT和OPL显示与对侧腮腺的SUVmax没有显着差异(WTp=0.79;OPLp=0.11),SUVmean(WTp=1.0;OPLp=0.08),肝商(WTp=0.5;OPLp=0.08)和血池商(WTp=0.8;OPLp=0.19)。两个PA和一个肉芽肿无法检查。在免疫组织化学分析中,所有PA均表现出最高的SSTR2表达强度(3级)。此外,PA具有高百分比的表达SSTR2的细胞(20%,80%和55%)。
结论:在68Ga-DOTATOCPET/CT中显示PA中的强示踪剂摄取。这可以允许医生利用放射性切除的生长抑素类似物PET/CT/MR成像来准确诊断PA。此外,将来有可能用非侵入性肽受体放射性核素疗法或生长抑素类似物治疗PA.
BACKGROUND: Currently, the diagnosis of salivary gland tumors using imaging techniques is unreliable.
METHODS: In this monocentric retrospective study, we examined patients who received a 68Ga-DOTATOC PET/CT and subsequently underwent a salivary gland tumor resection between 1 January 2010 and 31 December 2021. PET/CT image assessment was compared with somatostatin receptor (SSTR) expression and histology.
RESULTS: Thirteen patients (five pleomorphic adenoma (PA) and eight other parotid lesions (OPL)) received a 68Ga-DOTATOC PET/CT. Imaging displayed strong focal tracer uptake in all PA except for one with strong tumor to background discrimination. PA revealed higher SUVmax, SUVmean, liver and blood pool quotients than those of Warthin tumors (WT) and of OPL. In comparison to the contralateral parotid, SUVmax (p = 0.02), SUVmean (p = 0.02), liver quotient (p = 0.03) and blood pool quotient (p = 0.03) were all significantly higher. In contrast, WT and OPL showed in relation to the contralateral parotid no significant differences of SUVmax (WT p = 0.79; OPL p = 0.11), SUVmean (WT p = 1.0; OPL p = 0.08), liver quotient (WT p = 0.5; OPL p = 0.08) and blood pool quotient (WT p = 0.8; OPL p = 0.19). Two PA and one granuloma were not available for examination. In the immunohistochemal analysis, all PA demonstrated the highest intensity of SSTR2 expression (grade 3). Furthermore, PA had a high percentage of cells expressing SSTR2 (20%, 80% and 55%).
CONCLUSIONS: A strong tracer uptake in PA was shown in 68Ga-DOTATOC PET/CT. This may allow physicians to utilize radioligated somatostatin analogue PET CT/MR imaging to accurately diagnose PA. Additionally, it may be possible in the future to treat the PA with a noninvasive peptide receptor radionuclide therapy or with somatostatin analogues.