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Detection of Bone Metastases in Patients with Endocrine Gastroenteropancreatic Tumors: Bone Scintigraphy Compared with Somatostatin Receptor Scintigraphy

Departments of Nuclear Medicine, Gastroenterology and Surgery, Hôpital Bichat, Paris, France

Correspondence: For correspondence or reprints contact: Rachida Lebtahi, MD, Service de Médecine Nucléaire, Hôpital Bichat, 46 rue Henri Huchard, 75018 Paris, France.

ABSTRACT

Scintigraphy with somatostatin analogs is a sensitive method for the staging and therapeutic management of patients with endocrine gastroenteropancreatic (GEP) tumors. The aim of this study was to compare prospectively somatostatin receptor scintigraphy (SRS) using ¹¹¹In-pentetreotide with bone scintigraphy using ^99mTc-hydroxymethylene diphosphonate for the detection of bone metastases. Methods:: One-hundred-forty-five patients with proven endocrine GEP tumors were investigated. Patients were classified according to the presence of bone metastases as indicated by CT, MRI or histologic data. Group I included 19 patients with confirmed bone metastases, and group II included 126 patients without bone metastases. Results:: In group I, SRS was positive in all 19 patients with bone metastases, and bone scintigraphy was positive in 17 patients. Bone metastases were found to occur predominantly in patients with liver metastases. In group II, 5 patients had recent bone surgery for fracture or arthritis. SRS showed bone uptake in 4 of these patients, and bone scanning showed abnormal uptake in 5. In 7 of the remaining 121 group II patients, SRS was negative and bone scanning showed abnormal bone uptake suggesting bone metastases. The detection of bone metastases was of major prognostic value, because 42% of group 1 patients died during a 2-y follow-up. Conclusion:: In patients with GEP tumors, the accuracy of SRS appears to be similar to that of bone scintigraphy for the detection of bone metastases.

Key Words: somatostatin receptor scintigraphy • bone scintigraphy • gastroenteropancreatic tumor • bone metastases

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