Abstract
We evaluated octreotide scintigraphy in 81 untreated patients who were suspected of having bronchial carcinoma. Octreotide scintigraphy visualized the primary tumour in all of 40 patients with non-smallcell lung carcinoma (non-SCLC), and all of 26 patients with SCLC. In the remaining patients, other bronchial disease and metastases from extrapulmonary carcinomas were also visualized. Mediastinal lymph node involvement and distant metastases were recognized in 5 of 15 and 1 of 7 patients with non-SCLC, respectively. In vitro, none of the non-SCLCs were shown to bear somatostatin receptors. We postulate that the visualization of non-SCLC during octreotide scintigraphy is caused by binding of labelled octreotide to activated leucocytes or to proliferating neuroendocrine cells around the tumours. In patients with SCLC, radiologically suspected lymph node involvement was visualized for 21 of 25 sites. Distant metastases, especially to the liver and abdomen, were missed for 14 of 20 sites, most probably because no laxatives were administered and single photon emission tomography of the abdomen was not performed. The failure to recognize liver metastases is most probably due to a comparable uptake of radioactivity by the surrounding normal liver tissue. In 15 of 26 patients, previously unrecognized tumour sites were suggested during octreotide scintigraphy, leading to a downstaging of 5 of 14 patients with limited disease. Unexpected cerebral metastases were suggested in five patients with either limited or extensive disease. In all four of these for whom follow-up was available, cerebral metastases became manifest 5–8 months after octreotide scintigraphy. We conclude (1) that octreotide scintigraphy is of no use to differentiate SCLC from other lung disease, and (2) that octreotide scintigraphy should be included in the staging procedure of SCLC because it may allow early detection of metastases, especially to the brain.
Similar content being viewed by others
References
Krenning EP, Bakker WH, Kooij PPM, Breeman WAP, Oei HY, De Jong M, Reubi JC, Visser TJ, Kwekkeboom DJ, Reijs AEM, Van Hagen PM, Koper JW, Lamberts SWJ. Somatostatin receptor scintigraphy with [111In-DTPA-d-Phe1]-octreotide in man: metabolism, dosimetry and comparison with [123I-Tyr3]-octreotide.
Lamberts SWJ, Krenning EP, Reubi JC. The role of somatostatin and its analogs in the diagnosis and treatment of tumors. EndocrRev 1991;12:450–482.
Krenning EP, Kwekkeboom DJ, Bakker WH, Breeman WAP, Kooij PPM, Oei HY, Van Hagen M, De Jong M, Reubi JC, Visser TJ, Reijs AEM, Hofland LJ, Koper JW, Lamberts SWJ. Somatostatin receptor scintigraphy with [111In-DTPA-d-Phe1]-octreotide in man: metabolism, dosimetry and comparison with [123I-Tyr3]-octreotide: the Rotterdam experience with over 1000 patients. Eur J Nucl Med, 1993;716–731.
Kwekkeboom DJ, Krenning EP, Bakker WH, Oei HY, Splinter TAW, Kho GS, Lamberts SWJ. Radioiodinated somatostatin analog scintigraphy in small cell lung cancer. J Nucl Med 1991;32:1845–1848.
Bakker WH, Krenning EP, Reubi JC, Breeman WAP, Setyono-Han B, de Jong M, Kooij PPM, Bruns C, van Hagen PM, Marbach P, Visser TJ, Lamberts SWJ. In vivo application of [111In-DTPA-shirlyD-Phe1]-octreotide for detection of somatostatin receptor-positive tumors in rats. Life Sci 1991;49:1593–1601.
Bakker WH, Albert R, Bruns C, Breeman WAP, Hofland LJ, Marbach P, Pless J, Koper JW, Lamberts SWJ, Visser TJ, Krenning EP [111In-DTPA-shirlyD-Phe1]-octreotide, a potential radiopharmaceutical for imaging of somatostatin receptor-positive tumors: synthesis, radiolabeling and in vitro validation. Life Sci 1991;49:1583–1591.
Reubi JC, Heitz PU, Landolt AM. Visualization of somatostatin receptors and correlation with immunoreactive growth hormone and prolactin in human pituitary adenomas: evidence for different tumor subclasses. J Clin Endocrinol Metab 1987; 65:65–73.
Reubi JC, Waser B, Sheppard M, Macaulay V Somatostatin receptors are present in small-cell but not in non-small-cell primary lung carcinomas: relationship to EGF-receptors. Int J Cancer 1990;45:269–274.
Kondo K, Noguchi M, Mukai K, Matsuno Y, Sato Y, Shimosato Y, Monden Y Transferrin receptor expression in adenocarcinoma of the lung as a histopathologic indicator of prognosis. Chest 1990;97:1367–1371.
Sato Y, Watanabe S, Kodama T, Goto M, Shimosato Y. Stainability of lung cancer cells with Leu-7 and OKT-9 monoclonal antibodies. Jpn J Clin Oncol 1985;15:537–544.
Reubi JC, Horisberger U, Waser B, Gebbers JO, Laissue J. Preferential location of somatostatin receptors in germinal centers of human gut lymphoid tissue. Gastroenterology 1992; 103:1207–1214.
Scicchitano R, Dazin P, Bienenstock J, Payan DG, Stanisz AM. Distribution of somatostatin receptors on murine spleen and Peyer's patch T and B lymphocytes. Brain Behav Immun 1987;1:173–183.
Hiruma K, Koike T, Nakamura H, Sumida T, Maeda T, Tomioka H, Yoshida S, Fujita T. Somatostatin receptors on human lymphocytes and leukaemia cells. Immunology 1990; 71:480–485.
Reznik-Schüller H. Sequential morphologic alterations in the bronchial epithelium of Syrian golden hamsters during N-nitrosomorpholine-induced pulmonary tumorigenesis. Am J Pathol 1977;89:59–66.
Gould VE, Linnoila RI, Memoli VA, Warren WH. Neuroendocrine components of the bronchopulmonary tract: hyperplasias, dysplasias, and neoplasms. Lab Invest 1983;49:519–537.
Sunday ME, Kaplan LM, Motoyama E, Chin WW, Spindel ER. Gastrin-releasing peptide (mammalian bombesin) gene expression in health and disease. Lab Invest1988;59:5–24.
Daly BDT Jr., Faling LJ, Bite G, Gale ME, Bankoff MS, Jung-Legg Y, Cooper AG, Snider GL. Mediastinal lymph node evaluation by computed tomography in lung cancer. J Thorac Cardiovasc Surg 1987;94:664–672.
Kwekkeboom DJ, Krenning EP, Bakker WH, Oei HY, Kooij PPM, Lamberts SWJ. Somatostatin analogue scintigraphy in carcinoid tumours. Eur J Nucl Med 1993;20:283–292.
Kwekkeboom DJ, Reubi JC, Lamberts SWJ, Bruining HA, Mulder AH, Oei HY, Krenning EP. In vivo somatostatin receptor imaging in medullary thyroid carcinoma. J Clin Endocrinol Metab 1993;76:1413–1417.
Taylor JE, Bogden AE, Moreau JP, Coy DH. In vitro and in vivo inhibition of human small cell lung carcinoma (NCIH69) growth by a somatostatin analogue. Biochem Biophys Res Commun 1988;153:81–86.
Moody TW, Pert CB, Gazdar AF, Carney DN, Minna JD. High levels of intracellular bombesin characterize human small-cell lung carcinoma. Science 1981; 214:1246–1248.
Cuttitta F, Carney DN, Mulshine J, Moody TW Fedorko J, Fischler A, Minna JD. Bombesin-like peptides can function as autocrine growth factors in human small-cell lung cancer. Nature 1985;316:823–826.
Macaulay VM, Everard MJ, Teale JD, Trott PA, Van Wyk JJ, Smith IE, Millar JL. Autocrine function for insulin-like growth factor I in human small cell lung cancer cell lines and fresh tumor cells. Cancer Res 1990;50:2511–2517.
Macaulay VM, Smith IE, Everard MJ, Teale JD, Reubi JC, Millar JL. Experimental and clinical studies with somatostatin analogue octreotide in small cell lung cancer. Br J Cancer 1991;64:451–456.
Schally AV. Oncological applications of somatostatin analogues. Cancer Res 1988;48:6977–6985.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kwekkeboom, D.J., Siang Kho, G., Lamberts, S.W.J. et al. The value of octreotide scintigraphy in patients with lung cancer. Eur J Nucl Med 21, 1106–1113 (1994). https://doi.org/10.1007/BF00181066
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00181066