New Imaging Modalities In The Evaluation Of Patients Wit

在皮质醇增多症(库欣、S综合征)患者中，约有10%~20%的患者存在促肾上腺皮质激素的异位分泌。在这些患者中，大约50%的患者无法找到ACTH的来源，尽管进行了非常详细和广泛的检查，包括影像研究，如计算机断层扫描、磁共振成像和使用常规小剂量111-铟-戊四核苷酸([111In-DTPA-D-Phe]-戊四核苷酸)的奥曲肽扫描。该方案测试[18F]-脱氧葡萄糖(FDG)正电子发射断层扫描(PET)或使用更大剂量的[111In-DTPA-D-Phe]-Phe能否成功定位异位ACTH产生的来源。到目前为止，氟脱氧葡萄糖PET扫描在不到30%的患者中成功识别了肿瘤，小剂量奥曲糖在40%以上的患者中成功地定位了肿瘤。在低剂量奥曲康扫描阴性的7名患者中，只有1名患者在高剂量奥曲康扫描下成功地定位了肿瘤。这项研究继续发现，与传统的成像方式相比，氟脱氧葡萄糖PET扫描和大剂量奥曲康扫描是否可以为异位库欣综合征患者提供额外的成像策略。

Between 10% and 20% of patients with hypercortisolism (Cushing?s syndrome) have ectopic production of adrenocorticotropin hormone (ACTH). In approximately 50% of these patients, the source of ACTH cannot be found despite very detailed and extensive examination including imaging studies such as computed tomography scanning, magnetic resonance imaging, and octreotide scan using the conventional low dose of 111-indium pentetreotide ([111In-DTPA-D-Phe]-pentetreotide). This protocol tests whether [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) scanning or use of a higher dose of [111In-DTPA-D-Phe]-pentetreotide can be used to localize successfully the source of ectopic ACTH production. To date fluorodeoxyglucose PET scanning successfully identified the tumor in less than 30% of patients.Low dose Octreoscan successfully localized the tumor in more than 40% of patients. High dose Octreoscan successfully localized the tumor in only one patient out of seven patients in whom low dose Octreoscan was negative. This study continues to find out whether fluorodeoxyglucose PET scanning and high dose Octreoscan compared to conventional imaging modalities can provide additional imaging strategies for patients with ectopic Cushing's syndrome.