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Role of ^99mTc-Octreotide Acetate Scintigraphy in Suspected Lung Cancer Compared with ¹⁸F-FDG Dual-Head Coincidence Imaging

¹ Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China; ² Respiratory Department, Nanjing First Hospital, Nanjing Medical University, Nanjing, China; and ³ Respiratory Department, Nanjing Chest Hospital, Nanjing, China

Correspondence: For correspondence or reprints contact: Zizheng Wang, MD, Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, 68 Changle Rd., Nanjing, China, 210006. E-mail: zzwang136{at}yahoo.com.on

The aim of this study was to evaluate the clinical value of tomographic ^99mTc-octreotide acetate (hereafter, ^99mTc-octreotide) scintigraphy in the detection of patients with suspected lung cancer in comparison with that of ¹⁸F-FDG dual-head coincidence imaging (DHC). Methods: Forty-four consecutive patients with suspected pulmonary neoplasms underwent tomographic ^99mTc-octreotide scintigraphy and ¹⁸F-FDG coincidence imaging using the same gantry. The region of interest was drawn on the entire primary lesion. The tumor-to-normal tissue tracer values for both ^99mTc-octreotide and ¹⁸F-FDG were determined using region of interests and expressed as T/N_r and T/N_m, respectively. Final diagnosis was confirmed by histopathologic analysis or clinical follow-up. Results: Thirty-one of the 44 patients had lung cancer—6 with small cell lung cancer (SCLC) and 25 with non–small cell lung cancer (NSCLC). Thirteen of the 44 patients had benign lung lesions. The sensitivity, specificity, positive predictive value, and negative predictive value of ^99mTc-octreotide were 100%, 75.7%, 90.1%, and 100%, respectively, and of ¹⁸F-FDG DHC were 100%, 46.1%, 83.8%, and 100%, respectively. In the 31 patients with malignant tumors, all 38 abnormal lymph nodes in 20 patients showed abnormal high focal uptake of ¹⁸F-FDG; only 7 patients with 10 regional lymph adenopathies showed moderate uptake of ^99mTc-octreotide. Thirteen patients with 39 distant sites of abnormal uptake visualized (imaging stage IV) with ^99mTc-octreotide included 2 patients with brain metastases, 6 patients with pleural invasion and multiple bone metastasis, 2 patients with contralateral internal lung metastasis and pleural invasion, and 3 patients with only multiple bone metastasis. The final diagnosis was confirmed by histopathology or clinical follow-up. Conclusion: The sensitivity of ^99mTc-octreotide for the detection of lung cancer at the primary lesion was comparable with that of ¹⁸F-FDG coincidence imaging. Tomographic ^99mTc-octreotide scintigraphy had lower sensitivity for the detection of hilar and mediastinal lymph node metastasis compared with that of ¹⁸F-FDG coincidence PET, but it had high sensitivity for the detection of remote metastatic lesions. However, because of the small population, further investigation is necessary.

Key Words: lung cancer • scintigraphy • somatostatin receptor scintigraphy • ¹⁸F FDG • dual-head coincidence imaging

COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.

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