目的:使用111In-DTPA-DPhe1-奥曲肽(pentetreotide)的生长抑素受体闪烁显像(SRS)已成为神经内分泌肿瘤治疗不可或缺的一部分。缺乏精确的量化是SRS的缺点。本研究旨在使标准化摄取值(SUV)适应SRS,建立肝脏生理摄取的SUV范围,肾,和脾脏,并阐明联合视觉和定量SRS评估对神经内分泌肿瘤(NETs)分期和再分期的实用性。
方法:本研究包括21例接受111In-pentetreotideSRS的NETs患者。使用骨单光子发射计算机断层扫描(SPECT)定量分析软件(GI-BONE)计算生理和病理摄取的SUV。对于可视化分析,在平面和SPECT图像上使用5点量表对原发灶和转移灶进行视觉评分.我们评估了肝脏SUV之间的关系,肾,和脾脏处于双相,在定量指标中,视觉评分,和病理病变分类。
结果:评估了63个NEN病变。平均±标准偏差最大SUV(SUVmax)为肝脏:4小时,2.6±1.0;24h,2.2±1.0;肾:4小时,8.9±1.8;24小时,7.0±2.0;和脾脏;4小时,11.3±4.5;24h,11.5±7.6。在双相SPECT上,较高的SUVmax与较高的视觉评分显着相关(4h,p<0.001;24小时,p<0.001)(4小时:得分3和4,p<0.05;得分3和5:p<0.01;得分4和5:p<0.01;24小时:得分3和4,p=0.0748;得分3和5:p<0.01;得分4和5:p<0.01)。
结论:我们使SUV适应SRS,并建立了SUV在肝脏中生理摄取的范围,肾,还有脾脏.结合视觉和定量评估可用于更详细地成像单个病变,并可能作为新的SRS肿瘤标志物,用于NETs的分期和再分期。
OBJECTIVE: Somatostatin receptor scintigraphy (SRS) using 111In-DTPA-DPhe1-octreotide (pentetreotide) has become an integral part of neuroendocrine neoplasm management. The lack of precise quantification is a disadvantage of SRS. This study aimed to adapt the standardized uptake value (SUV) to SRS, establish the SUV range for physiological uptake in the liver, kidney, and spleen, and elucidate the utility of combined visual and quantitative SRS assessment for staging and restaging of neuroendocrine tumors (NETs).
METHODS: This study included 21 patients with NETs who underwent 111In-pentetreotide SRS. The SUV of physiological and pathological uptake was calculated using bone single-photon emission computed tomography (SPECT) quantitative analysis software (GI-BONE). For visual analysis, the primary and metastatic lesions were scored visually on planar and SPECT images using a five-point scale. We assessed the relationships between the SUVs of the liver, kidney, and spleen in the dual phase, and among quantitative indices, visual score, and pathological lesions classification.
RESULTS: Sixty-three NEN lesions were evaluated. The mean ± standard deviation maximum SUVs (SUVmax) were liver: 4 h, 2.6 ± 1.0; 24 h, 2.2 ± 1.0; kidney: 4 h, 8.9 ± 1.8; 24 h, 7.0 ± 2.0; and spleen; 4 h, 11.3 ± 4.5; 24 h, 11.5 ± 7.6. Higher SUVmax was significantly associated with higher visual scores on dual-phase SPECT (4 h, p < 0.001; 24 h, p < 0.001) (4 h: scores 3 and 4, p < 0.05; scores 3 and 5: p < 0.01; scores 4 and 5: p < 0.01; 24 h: scores 3 and 4, p = 0.0748; scores 3 and 5: p < 0.01; scores 4 and 5: p < 0.01).
CONCLUSIONS: We adapted the SUV to SRS and established the range of SUV for physiological uptake in the liver, kidney, and spleen. Combined visual and quantitative assessment is useful for imaging individual lesions in greater detail, and may serve as a new tumor marker of SRS for staging and restaging of NETs.