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Factors Predicting Tracer Uptake in Somatostatin Receptor and MIBG Scintigraphy of Metastatic Gastroenteropancreatic Neuroendocrine Tumors

Samer Ezziddin, MD1, Timur Logvinski, MD1, Charlotte Yong-Hing, MD2, Hojjat Ahmadzadehfar, MD1, Hans-Peter Fischer, MD3, Holger Palmedo, MD1, Jan Bucerius, MD1, Michael J. Reinhardt, MD1 and Hans-Jürgen Biersack, MD1

1 Department of Nuclear Medicine, University of Bonn, Bonn, Germany; 2 Department of Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada; and 3 Department of Pathology, University of Bonn, Bonn, Germany


Figure 1
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  		FIGURE 1.  Proportions of patients displaying sufficient tracer accumulation with regard to targeted radiotherapy.

 

Figure 2
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  		FIGURE 2.  Comparison of tracer-positive proportions between GE-NET and P-NET shown for both tracers. NS = not significant.

 

Figure 3
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  		FIGURE 3.  MRI (A), 111In-pentetreotide (B), and 123I-MIBG (C) scans of a patient with metastatic nonfunctioning P-NET demonstrate intense Oct uptake in liver and lymph node metastases and the large primary lesion (A and B, arrows). These findings are in contrast to the virtually negative MIBG scan, showing only partial uptake in 1 metastatic lesion in left liver lobe (C, arrow to right), with rest of tumor lesions being negative; note the cold area (C, thin arrow) in the right liver lobe corresponding to the major metastatic site.

 

Figure 4
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  		FIGURE 4.  Comparison of tracer-positive proportions between low-grade malignant (LGM) and high-grade malignant (HGM) tumors for both tracers. F = functioning; NF = nonfunctioning.

 

Figure 5
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  		FIGURE 5.  Comparison of tracer-positive proportions between functioning (F) and nonfunctioning (NF) GEP-NET for both tracers: low-grade malignant (LGM) NF GEP-NET after exclusion of malignancy for separate analysis of functionality.

 

Figure 6
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  		FIGURE 6.  Comparison of tracer-positive proportions between functioning (F) and nonfunctioning (NF) low-grade malignant (LGM) GE-NET with liver metastases

 

Figure 7
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  		FIGURE 7.  CT (A), 111In-pentetreotide (B), and 123I-MIBG (C) images of a patient with advanced functioning EC cell carcinoid disease show multiple metastases to liver and intense uptake of both tracers. Additional site of uptake (B, left arrow) belongs to right kidney. MIBG scan depicts another hepatic lesion (C, upper arrow) obscured in pentetreotide imaging by physiologic splenic uptake. One metastatic pelvic bone lesion (B and C, arrows to lower right) is also better visualized in the MIBG scan.

 




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