Current knowledge on the sensitivity of the (68)Ga-somatostatin receptor positron emission tomography and the SUVmax reference range for management of pancreatic neuroendocrine tumours.
Current knowledge on the sensitivity of the (68)Ga-somatostatin receptor positron emission tomography and the SUVmax reference range for management of pancreatic neuroendocrine tumours.
复制标题
DOI：
10.1007/s00259-016-3395-4
复制
发表时间：
2016-10
影响因子：
9.1
通讯作者：
Uprimny, Christian
中科院分区：
文献类型：
--
作者：
Virgolini, Irene;Gabriel, Michael;Kroiss, Alexander;von Guggenberg, Elisabeth;Prommegger, Rupert;Warwitz, Boris;Nilica, Bernhard;Roig, Ilanos Geraldo;Rodrigues, Margarida;Uprimny, Christian
关键词：
在注射用于生长抑素（sst）受体（r）成像的三种68 Ga标记的奥曲肽之一后，超过三分之一的患者观察到头部/钩突的胰腺摄取生理性增加。在成像设置中，这些68 Ga-sstr结合肽之间存在微小差异。在68 Ga-sstr-成像上，生理摄取可以是弥漫性的或局灶性的，并且通常随时间保持稳定。正常胰腺和胰腺神经内分泌肿瘤（PNET）病变报告的最大标准化摄取值（SUVmax）的差异可能与几个因素有关，包括（a）肽结合亲和力的差异以及胰腺α和β细胞sstr亚型表达的差异，以及肿瘤细胞的异质性/密度，（B）扫描仪分辨率的差异，图像重建技术和采集协议，（c）大多数是回顾性研究设计，（d）混合患者人群，或（e）药物干扰，如长效SST类似物治疗。大多数研究的主要局限性在于缺乏对异常结果的组织病理学证实。生理性胰腺和头部/钩突PNET病变的SUVmax计算值之间存在显著重叠，不利于在临床环境中使用定量参数。传闻中的长期随访研究甚至表明，头部/钩突的摄取增加在多年的随访中仍然可能是恶性的。胰体和胰尾的SUV最大值数据有限。因此，无论定量参数如何，胰腺中任何可见的局灶性示踪剂摄取都必须被视为恶性肿瘤的可疑。一般而言，sstr-PET/CT对NET患者的管理具有重要意义，导致约三分之一患者的治疗决定发生变化。因此，如果观察到头部/钩突中的摄取，则在临床环境中必须使用68 Ga-sstr-PET/CT进行随访。
Physiologically increased pancreatic uptake at the head/uncinate process is observed in more than one-third of patients after injection of one of the three 68Ga-labelled octreotide-based peptides used for somatostatin (sst) receptor (r) imaging. There are minor differences between these 68Ga-sstr-binding peptides in the imaging setting. On 68Ga-sstr-imaging the physiological uptake can be diffuse or focal and usually remains stable over time. Differences in the maximal standardised uptake values (SUVmax) reported for the normal pancreas as well as for pancreatic neuroendocrine tumour (PNET) lesions may be related to several factors, including (a) differences in the peptide binding affinities as well as differences in sstr subtype expression of pancreatic α- and β-cells, and heterogeneity / density of tumour cells, (b) differences in scanner resolution, image reconstruction techniques and acquisition protocols, (c) mostly retrospective study designs, (d) mixed patient populations, or (e) interference with medications such as treatment with long-acting sst analogues. The major limitation in most of the studies lies in the lack of histopathological confirmation of abnormal findings. There is a significant overlap between the calculated SUVmax-values for physiological pancreas and PNET-lesions of the head/uncinate process that do not favour the use of quantitative parameters in the clinical setting. Anecdotal long-term follow-up studies have even indicated that increased uptake in the head/uncinate process still can turn out to be malignant over years of follow up. SUVmax-data for the pancreatic body and tail are limited. Therefore, any visible focal tracer uptake in the pancreas must be considered as suspicious for malignancy irrespective of quantitative parameters. In general, sstr-PET/CT has significant implications for the management of NET patients leading to a change in treatment decision in about one-third of patients. Therefore, follow-up with 68Ga-sstr-PET/CT is mandatory in the clinical setting if uptake in the head/uncinate process is observed.
登录
查看更多内容
影响因子：
7.7
作者：
Kumar, U;Sasi, R;Patel, YC
通讯作者：
Patel, YC
影响因子：
9.3
作者：
Castellucci, Paolo;Ucha, Javier Pou;Fanti, Stefano
通讯作者：
Fanti, Stefano
影响因子：
3.7
作者：
Ilhan, Harun;Fendler, Wolfgang P.;Haug, Alexander R.
通讯作者：
Haug, Alexander R.
影响因子：
5.9
作者：
Kumar, Rakesh;Sharma, Punit;Malhotra, Arun
通讯作者：
Malhotra, Arun
影响因子：
4.4
作者：
Kloeppel, Gunter;Anlauf, Martin;Sipos, Bence
通讯作者：
Sipos, Bence