Skip to main content
SpringerLink
Log in

Improved tumour detection by gastrin receptor scintigraphy in patients with metastasised medullary thyroid carcinoma

  • Original article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Radiopeptide imaging is a valuable imaging method in the management of patients with neuroendocrine tumours (NET). To determine the clinical performance of gastrin receptor scintigraphy (GRS), it was compared with somatostatin receptor scintigraphy (SRS), computed tomography (CT) and 18F-FDG positron emission tomography (PET) in patients with metastasised/recurrent medullary thyroid carcinoma (MTC).

Methods

Twenty-seven consecutive patients underwent imaging with GRS, SRS (19 patients), CT and PET (26 patients). GRS and SRS were compared with respect to tumour detection and uptake. CT, PET, magnetic resonance imaging (MRI), ultrasound (US) and follow-up were used for verification of findings. In addition, GRS, CT and PET were directly compared with each other to determine which method performs best.

Results

Nineteen patients underwent both GRS and SRS. Among these, GRS showed a tumour detection rate of 94.2% as compared to 40.7% for SRS [mean number of tumour sites (±SD) and 95% confidence intervals (CI): GRS 4.3±3.1/2.8–5.7, SRS 1.8±1.6/1.1–2.6]. In 26 patients, GRS, CT and PET were compared. Here, GRS showed a tumour detection rate of 87.3% (CT 76.1%, PET 67.2%; mean number of tumour sites and 95% CI: GRS 4.5±4.0/2.9–6.1, CT 3.9±3.5/2.5–5.3, PET 3.5±3.3/2.1–4.8). If GRS and CT were combined, they were able to detect 96.7% of areas of tumour involvement.

Conclusion

GRS had a higher tumour detection rate than SRS and PET in our study. GRS in combination with CT was most effective in the detection of metastatic MTC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Krenning EP, Kwekkeboom DJ, Bakker WH, Breeman WA, Kooij PP, Oei HY, et al. Somatostatin receptor scintigraphy with (111In-DTPA-D-Phe1)- and (123I-Tyr3)-octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med 1993;20:716–731

    Article  PubMed  CAS  Google Scholar 

  2. Modlin IM, Tang LH. Approaches to the diagnosis of gut neuroendocrine tumours: the last word today. Gastroenterology 1997;112:583–590

    Article  PubMed  CAS  Google Scholar 

  3. Ricke J, Klose KJ, Mignon M, Öberg K, Wiedenmann B. Standardisation of imaging in neuroendocrine tumours: results of a European Delphi process. Eur J Radiol 2001;37:8–17

    Article  PubMed  CAS  Google Scholar 

  4. Lamberts SW, Bakker WH, Reubi JC, Krenning EP. Somatostatin-receptor imaging in the localization of endocrine tumours. N Engl J Med 1990;323:1246–1249

    Article  PubMed  CAS  Google Scholar 

  5. Bakker WH, Krenning EP, Reubi JC, Breeman WA, Setyono-Han B, de Jong M, et al. In vivo application of [111In-DTPA-D-Phe1]-octreotide for detection of somatostatin receptor-positive tumours in rats. Life Sci 1991;49:1593–1601

    Article  PubMed  CAS  Google Scholar 

  6. Termanini B, Gibril F, Reynolds JC, Dopman JL, chen CC, Stewart CA, et al. Value of somatostatin receptor scintigraphy: a prospective study in gastrinoma of its effect on clinical management. Gastroenterology 1997;112:335–347

    Article  PubMed  CAS  Google Scholar 

  7. Lebtahi R, Cadiot G, Sarda L, Daou D, Faraggi M, Petegnief Y, et al. Clinical impact of somatostatin receptor scintigraphy in the management of patients with neuroendocrine gastroenteropancreatic tumours. J Nucl Med 1997;38:853–858

    PubMed  CAS  Google Scholar 

  8. Behr TM, Gratz S, Markus PM, Dunn RM, Hufner M, Schauer A, et al. Anti-carcinoembryonic antigen antibodies versus somatostatin analogs in the detection of metastatic medullary thyroid carcinoma: are carcinoembryonic antigen and somatostatin receptor expression prognostic factors? Cancer 1997;80:2436–2457

    Article  PubMed  CAS  Google Scholar 

  9. Diehl M, Risse JH, Brandt-Mainz K, Dietlein M, Bohuslavizki KH, Matheja P, et al. Fluorine-18 fluorodeoxyglucose positron emission tomography in medullary thyroid cancer: results of a multicentre study. Eur J Nucl Med 2001;28:1671–1676

    Article  PubMed  CAS  Google Scholar 

  10. Szakáll S, Ésik O, Bajzik G, Repa I, Dabasi G, Sinkovics I, et al.18F-FDG PET detection of lymph node metastases in medullary thyroid carcinoma. J Nucl Med 2002;43:66–71

    PubMed  Google Scholar 

  11. Brandt-Mainz K, Müller SP, Görges R, Saller B, Bokisch A. The value of fluorine-18 fluorodeoxyglucose PET in patients with medullary thyroid cancer. Eur J Nucl Med 2000;27:490–496

    Article  PubMed  CAS  Google Scholar 

  12. Högerle S, Altehöfer C, Ghanem N, Brink I, Moser E, Nitzsche E.18F-DOPA positron emission tomography for tumour detection in patients with medullary thyroid carcinoma and elevated calcitonin levels. Eur J Nucl Med 2001;28:64–71

    Article  Google Scholar 

  13. Gotthardt M, Battmann A, Höffken H, Schurrat T, Pollum H, Beuter D, et al. 18F-FDG-PET, somatostatin receptor scintigraphy, and CT in metastatic medullary thyroid carcinoma: a clinical study and an analysis of the literature. Nucl Med Commun 2004;25:439–443

    Article  PubMed  CAS  Google Scholar 

  14. Gimm O, Sutter T, Dralle H. Diagnosis and therapy of sporadic and familial medullary thyroid carcinoma. J Cancer Res Clin Oncol 2001;127:156–165

    Article  PubMed  CAS  Google Scholar 

  15. Behr TM, Jenner M, Béhé M, Angerstein C, Gratz S, Raue F, et al. Radiolabelled peptides for targeting of cholecystokinin-B/gastrin receptor expressing tumours: from preclinical development to initial clinical results. J Nucl Med 1999;40:1029–1044

    PubMed  CAS  Google Scholar 

  16. Juweid M, Sharkey RM, Behr T, Swayne LC, Rubin AD, Herskovic T, et al. Improved detection of medullary thyroid cancer with radiolabelled antibodies to carcinoembryonic antigen. J Clin Oncol 1996;14:1209–1217

    PubMed  CAS  Google Scholar 

  17. Busnardo B, Girelli ME, Simioni N, Nacamulli D, Bosetto E. Nonparallel patterns of calcitonin and carcinoembryonic antigen levels in the follow-up of medullary thyroid carcinoma. Cancer 1984;53:278–285

    Article  PubMed  CAS  Google Scholar 

  18. Virgolini I, Raderer M, Kurtaran A, Angelberger P, Banyai S, Yang Q, et al. Vasoactive intestinal peptide-receptor imaging for the localization of intestinal adenocarcinomas and endocrine tumours. N Engl J Med 1994;331:1116–1121

    Article  PubMed  CAS  Google Scholar 

  19. Hessenius C, Bäder M, Meinhold H, Bohmig M, Faiss S, Reubi JC, et al. Vasoactive intestinal peptide receptor scintigraphy in patients with pancreatic adenocarcinomas or neuroendocrine tumours. Eur J Nucl Med 2000;27:1684–1693

    Article  PubMed  CAS  Google Scholar 

  20. De Visser M, Janssen PJJM, Srinivasan A, Reubi JC, Waser B, Erion JL, et al. Stabilised 111In-labelled DTPA- and DOTA-conjugated neurotensin analogues for imaging and therapy of exocrine pancreatic cancer. Eur J Nucl Med Mol Imag 2003;30:1134–1139

    Article  CAS  Google Scholar 

  21. Janssen ML, Oyen WJG, Dijkgraaf I, Massuger LF, Frielink C, Edwards DS, et al. Tumor targeting with radiolabelled αvβ3 integrin binding peptides in a nude mouse model. Cancer Res 2002;62:6146–6151

    PubMed  CAS  Google Scholar 

  22. Hennig IM, Laissue JA, Horisberger U, Reubi JC. Substance P receptors in human primary neoplasms. Int J Cancer 1995;61:786–792

    PubMed  CAS  Google Scholar 

  23. Gotthardt M, Boermann OC, Behr TM, Béhé MP, Oyen WJG. Development and clinical application of peptide-based radiopharmaceuticals. Curr Pharm Design 2004;10:2951–2963

    Article  CAS  Google Scholar 

  24. Reubi JC, Schaer JC, Laissue JA, Waser B. Somatostatin receptors and their subtypes in human tumours and in peritumoural vessels. Metab Clin Exp 1996;45(Suppl 1):39–41

    PubMed  CAS  Google Scholar 

  25. Sreedharan SP, Kodama KT, Peterson KE, Goetzl EJ. Distinct subsets of somatostatin receptors on cultured human lymphocytes. J Biol Chem 1989;264:949–953

    PubMed  CAS  Google Scholar 

  26. Blum JE, Handmaker H, Rinne NA. The utility of a somatostatin-type receptor binding peptide radiopharamceutical (P829) in the evaluation of solitary pulmonary nodules. Chest 1999;115:224–232

    Article  PubMed  CAS  Google Scholar 

  27. Stoffel M, Jamar F, Donckier J, Hainaut P, Decoster P, Beckers C, et al. Increased uptake of indium-111 pentetreotide up to 10 years after external thoracic irradiation: report of two cases. Eur J Nucl Med 1996;23:723–726

    Article  PubMed  CAS  Google Scholar 

  28. Verga U, Muratori F, Sacco G, Banfi F, Libroia A. The role of radiopharmaceuticals MIBG and (V)DMSA in the diagnosis of medullary thyroid carcinoma. Henry Ford Hosp Med J 1989;37(3–4):175–177

    PubMed  CAS  Google Scholar 

  29. Uğur Ö, Kostakoğlu L, Güler N, Kaner B, Uysal U, Elahi N, et al. Comparison of 99mTc(V)-DMSA. 201Tl, and 99mTc-MIBI imaging in the follow-up of patients with medullary carcinoma of the thyroid. Eur J Nucl Med 1996;23:1367–1371

    Article  PubMed  Google Scholar 

  30. Diehl M, Risse JH, Brandt-Mainz K, Dietlein M, Bohuslavitzki KH, Matheja P, et al. Fluorine-\ fluorodeoxyglucose positron emission tomography in medullary thyroid cancer: results of a multicentre study. Eur J Nucl Med 2001;28:1671–1676

    Article  PubMed  CAS  Google Scholar 

  31. Reubi JC, Waser B. Concomitant expression of several peptide receptors in neuroendocrine tumours: molecular basis for in vivo multireceptor imaging. Eur J Nucl Med Mol Imaging 2003;30:781–793

    Article  PubMed  CAS  Google Scholar 

  32. Béhé M, Kluge W, Becker W, Gotthardt M, Behr TM. Use of polyglutamic acids to reduce uptake of radiometal-labeled minigastrin in the kidneys. J Nucl Med 2005;46:1012–1015

    PubMed  Google Scholar 

  33. Maecke HR, Hofmann M, Haberkorn U. 68Ga-labeled peptides in tumor imaging. J Nucl Med 2005;46(Ssuppl 1):172S–178S

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Radboud University Nijmegen Medical Center, Postbus 9101, 6500 HB, Nijmegen, The Netherlands

    Martin Gotthardt & Wim J. G. Oyen

  2. Department of Nuclear Medicine, Philipps-University of Marburg, Marburg, Germany

    Martin P. Béhé, Daniela Beuter, Tino Schurrat, Meike Schipper, Halina Pollum & Thomas M. Behr

  3. Department of Diagnostic Radiology, Philipps-University of Marburg, Marburg, Germany

    Anke Battmann

  4. Institute of Theoretical Surgery, Philipps-University of Marburg, Marburg, Germany

    Artur Bauhofer

Authors
  1. Martin Gotthardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martin P. Béhé
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniela Beuter
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anke Battmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Artur Bauhofer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tino Schurrat
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Meike Schipper
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Halina Pollum
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Wim J. G. Oyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Thomas M. Behr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin Gotthardt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gotthardt, M., Béhé, M.P., Beuter, D. et al. Improved tumour detection by gastrin receptor scintigraphy in patients with metastasised medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging 33, 1273–1279 (2006). https://doi.org/10.1007/s00259-006-0157-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-006-0157-8

Keywords

Search

Navigation