Medical Radiology and Radiation Safety. 2024. Vol. 69. № 4
DOI:10.33266/1024-6177-2024-69-4-88-93
R.V. Zelchan, A.A. Medvedeva, O.D. Bragina, A.N. Rуbina,
E.A. Dudnikova, V.V. Visotskaya, V.E. Goldberg, V.I. Chernov
Spect/Ct with a New Radiopharmaceutical “99mtc, Octreotide” in Diagnosis and Evaluation of the Effectiveness of Treatment of Neuroendocrine Tumor of the Lung (Clinical Case)
Cancer Research Institute, Tomsk National Research Medical Center, Tomsk, Russia
Contact person: R.V. Zelchan, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Purpose: to demonstrate the possibilities of using SPECT/CT with the new radiopharmaceutical “99mTс, Octreotide” in the diagnosis, assessment of the extent of the process and monitoring of the effectiveness of treatment of neuroendocrine lung tumors.
Material and methods: the presented clinical case examines the medical history of a patient with verified neuroendocrine cancer of the right lung with extensive local spread and the presence of distant lymph node metastases (retroperitoneal lymph nodes) and hematogenous dissemination to bones (ribs and vertebrae). During the initial diagnosis and at the stages of chemotherapy treatment, along with traditional methods of instrumental and laboratory examination, the patient underwent “99mTc, Octreotide” SPECT/CT. The results of the study were assessed visually and using the SUV (standardized accumulation level). When interpreting the results of “99mTc, Octreotide” SPECT/CT with special attention was paid to the dynamics of the SUV indicator at control points for assessing the effectiveness of chemotherapy
treatment.
Results: The results obtained demonstrated the possibility of effective use of “99mTc, Octreotide” SPECT/CT at the stage of primary diagnosis of a neuroendocrine tumor. The data obtained not only confirmed the presence of a malignant tumor of a neuroendocrine nature in the patient, but also made it possible to correctly stage the tumor process, since additional pathological foci were identified in distant lymph nodes and bones. In addition, the use of “99mTc, Octreotide” SPECT/CT during control examinations at the stages of chemotherapy treatment of a patient made it possible to supplement the significance of diagnostic information obtained using traditional research methods and to more reliably assess the effectiveness of the therapy. Already at the first control examination, pronounced positive dynamics were observed after 3 courses of chemotherapy in the form of a decrease in the number of foci of pathological accumulation of “99mTc, Octreotide” and a decrease in the intensity of its inclusion in the remaining areas of the tumor lesion. Also, during further examinations at control points, the opposite – negative dynamics was noted in the form of the appearance of new foci of pathological accumulation of “99mTc, Octreotide”.
Conclusion: The presented experience in the clinical use of “99mTc, Octreotide” SPECT/CT demonstrated the effectiveness and ease of use of this method in patients with neuroendocrine tumors. In addition, the results obtained today make it possible to successfully use the new domestic radiopharmaceutical for the diagnosis of neuroendocrine tumors.
Keywords: radiopharmaceutical, neuroendocrine tumor of the lung, 99mTc-octreotide, SPECT/CT
For citation: Zelchan RV, Medvedeva AA, Bragina OD, Rуbina AN, Dudnikova EA, Visotskaya VV, Goldberg VE, Chernov VI. Spect/Ct with a New Radiopharmaceutical “99mtc, Octreotide” in Diagnosis and Evaluation of the Effectiveness of Treatment of Neuroendocrine Tumor of the Lung (Clinical Case). Medical Radiology and Radiation Safety. 2024;69(4):88–93. (In Russian). DOI:10.33266/1024-6177-2024-69-4-88-93
References
1. Dasari A., Shen C., Halperin D., Zhao B., Zhou S., Xu Y., et al. Trends in the Incidence., Prevalence, and Survival Outcomes in Patients With Neuroendocrine Tumors in the United States. JAMA Oncol. 2017;3;10:1335–42. doi: http://dx.doi.org/10.1001/jamaon-col.2017.0589.
2. Reubi J.C., Waser B. Concomitant Expression of Several Peptide Receptors in Neuroendocrine Tumors: Molecular Basis for in Vivo Multi Receptor Tumor Targeting. Eur J Nucl Med Mol Imaging. 2003;30;5:781–793. doi: http://dx.doi.org/10.1007/s00259-003-1184-3.
3. Körner M. Specific Biology of Neuroendocrine Tumors: Peptide Receptors as Molecular Targets. Best Pract Res Clin Endocrinol Metab. 2016;30;1:19–31. doi: http://dx.doi.org/10.1016/j.beem.2016.01.001.
4. Deroose C.M., Hindié E., Kebebew E., Goichot B., Pacak K., Taïeb D., et al. Molecular Imaging of Gastroenteropancreatic Neuroendocrine Tumors: Current Status and Future Directions. J Nucl Med. 2016;57;12:1949–1956. doi: http://dx.doi.org/10.2967/ jnumed.116.179234.
5. Чойнзонов Е.Л., Чижевская С.Ю., Мусабаева Л.И., Фролова И.Г., Авдеев С.В., Синилкин И.Г., Зельчан Р.В., Суркова П.В., Кушнер А.В. Результаты комбинированного лечения больных раком гортани и гортаноглотки // Сибирский онкологический журнал. 2012. №1. С. 5-9. [Choynzonov E.L., Chizhevskaya S.Yu., Musabayeva L.I., Frolova I.G., Avdeyev S.V., Sinilkin I.G., Zel`chan R.V., Surkova P.V., Kushner A.V. Results of Combined Treatment of Patients with Cancer of the Larynx and Hypopharynx. Sibirskiy Onkologicheskiy Zhurnal = Siberian Journal of Oncology. 2012;1:5-9 (In Russ.)].
6. Chernov V.I., Sinilkin I.G., Zelchan R.V., Medvedeva A.A., Lyapunov A.Yu., Bragina O.D., Varlamova N.V., Skuridin V.S. Experimental Study of 99mTc-Aluminum Oxide Use for Sentinel Lymph Nodes Detection. AIP Conference Proceedings, 2016. P. 020012.
7. Тицкая А.А., Чернов В.И., Слонимская Е.М., Синилкин И.Г., Зельчан Р.В. Маммосцинтиграфия с 99mТс-МИБИ в диагностике рака молочной железы // Сибирский медицинский журнал. Г. Томск. 2010. Т. 25. № 4-1. С. 92-95. [Titskaya A.A., Chernov V.I., Slonimskaya E.M., Sinilkin I.G., Zel`chan R.V. Mammoscintigraphy with 99mTc-MIBI in the Diagnosis of Breast Cancer. Sibirskiy Meditsinskiy Zhurnal = The Siberian Medical Journal. Tomsk. 2010;25;4-1:92-95 (In Russ.)].
8. Bragina O., Chernov V., Zelchan R., Medvedeva A., Schulga A., Vorobyeva A., Orlova A., Deyev S., Tolmachev V., Konovalova E., Garbukov E., Tashireva L., Sorensen J. Phase I Trial of 99mTc-;HE3-G3., a DARPin-Based Probe for Imaging of HER2 Expression in Breast Cancer. Journal of Nuclear Medicine. 2022;63;4:528-535.
9. Delle Fave G., Kwekkeboom DJ., Van Cutsem E., Rindi G., Kos-Kudla B., Knigge U., et al. Barcelona Consensus Conference Participants. ENETS Consensus Guidelines for the Management of Patients with Gastroduodenal Neoplasms. Neuroendocrinology. 2012;95;2:74–87. doi: http://dx.doi.org/10.1159/000335595.
10. Koyasu S., Shimizu Y., Nakamoto Y. 68Ga-DOTATOC PET/CT for Diagnosing Neuroendocrine Tumors. Gan To Kagaku Ryoho. 2022;49;8:821-825.
11. Чернов В.И., Брагина О.Д., Зельчан Р.В., Медведева А.А., Синилкин И.Г., Ларькина М.С., Стасюк Е.С., Нестеров Е.А., Скуридин В.С. Меченые аналоги соматостатина в тераностике нейроэндокринных опухолей // Медицинская радиология и радиационная безопасность. 2017. Т.62. №3. С. 42-49. [Chernov V.I., Bragina O.D., Zel`chan
R.V., Medvedeva A.A., Sinilkin I.G., Lar`kina M.S., Stasyuk E.S., Nesterov E.A., Skuridin V.S. Labeled Somatostatin Analogues in Theranostics of Neuroendocrine Tumors. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost = Medical Radiology and Radiation Safety. 2017;62;3:42-49 (In Russ.)].
12. Briganti V., Cuccurullo V., Di Stasio GD., Mansi L. Gamma Emitters in Pancreatic Endocrine Tumors Imaging in the PET Era: Is there a Clinical Space for 99mTc-peptides? Curr Radiopharm. 2019;12;2:156-170. doi: 10.2174/1874471012666190301122524.
13. Briganti V., Cuccurullo V., Berti V., Di Stasio GD., Linguanti F., Mungai F., Mansi L. 99mTc-EDDA/HYNIC-TOC is a New Opportunity in Neuroendocrine Tumors of the Lung ;and in other Malignant and Benign Pulmonary Diseases. Curr Radiopharm. 2020;13;3:166-176. doi: 10.2174/1874471013666191230143610.
PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The work was carried out with the financial support of the Ministry of Education and Science of Russia. State contract 14.N08.11.0166 for the implementation of applied scientific research and experimental developments for state needs.
Contribution. Zelchan R.V.: collection and analysis of literary material, development of concept and design, analysis and interpretation of data, writing text; Chernov V.I.: development of concept and design, scientific editing of the text, final approval for publication of the manuscript; Rybina A.N., Medvedeva A.A., Bragina O.D.: development of the concept of research, development research design, data analysis; Dudnikova, V.V. Vysotskaya, V.E. Goldberg: collection of material, data analysis.
Article received: 20.03.2024. Accepted for publication: 25.04.2024.