Comparison of Single Time-Point [111-In] Pentetreotide SPECT/CT With Dual Time-Point Imaging of Neuroendocrine Tumors

作者：Wong Ka Kit^*; Wynn Elizabeth A; Myles Jamie; Ackermann Robert J; Frey Kirk A; Avram Anca M

来源：Clinical Nuclear Medicine, 2011, 36(1): 25-31.

DOI：10.1097/RLU.0b013e3181feedc0

• somatostatin receptor scintigraphy
• neuroendocrine tumor
• SPECT/CT

Purpose: To determine whether single time-point single-photon emission computed tomography-computed tomography (SPECT/CT) somatostatin receptor imaging can replace traditional dual time-point planar and SPECT somatostatin receptor scintigraphy for evaluation of neuroendocrine tumors.
Materials and Methods: Twenty-four patients (9 males, 15 females; mean age: 56 years; range: 14-82 years) underwent [111-In] pentetreotide scintigraphy, with planar whole-body images acquired at 24 and 48 hours after injection and abdominal SPECT/CT at 24 hours postinjection. Two blinded readers independently interpreted each study, using single time-point (24 hours planar and SPECT/CT) and separately using dual time-point (24-and 48-hours planar, and 24-hour SPECT without CT) image information. Consensus interpretations were compared with surgical pathology, or clinical and radiologic follow-up for at least 12 months.
Results: Interobserver agreement was excellent (kappa = 0.86) for single time-point imaging, and good (kappa = 0.56) with dual time-point imaging. After consensus review, single time-point imaging identified pathologic lesions in 11 of 12 subjects with diagnosis of NET at follow-up, and in 0 of 12 subjects without NET (sensitivity 92%; specificity 100%). Dual time-point imaging performed similarly, but missed an additional NET case (sensitivity 83%; specificity 100%). After review of SPECT/CT, the readers considered that additional 48 hours imaging was not necessary in the majority of cases, indicating high degree of confidence with the single time-point imaging.
Conclusion: [111-In] pentetreotide SPECT/CT imaging at 24 hours identifies pathologic disease sites and distinguishes physiologic activity equally well compared to traditional strategies using 2 imaging days. Routine use of SPECT/CT will allow single time-point imaging without loss of diagnostic accuracy, enhancing patient convenience, and clinical throughput.

• 出版日期2011-1