Skip to main content

Advertisement

SpringerLink
Log in

Concordance between results of somatostatin receptor scintigraphy with 111In-DOTA-DPhe1-Tyr3-octreotide and chromogranin A assay in patients with neuroendocrine tumours

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

Abstract

Purpose

Somatostatin receptor scintigraphy (SRS) and chromogranin A (CgA) assay have successfully been implemented in the clinical work-up and management of neuroendocrine tumour (NET) patients. However, there is still a lack of studies comparing results in these patients. Our aim was to compare directly in NET patients SRS and CgA assay results with special regard to tumour features such as grade of malignancy, primary origin, disease extent and function.

Methods

One hundred twenty consecutive patients with histological confirmed NETs were investigated with 111In-DOTA-DPhe1-Tyr3-octreotide (111In-DOTA-TOC) SRS and CgA immunoradiometric assay. Tumours were classified by cell characteristics [well-differentiated NETs, well-differentiated neuroendocrine carcinomas, poorly differentiated neuroendocrine carcinomas (PDNECs)], primary origin (foregut, midgut, hindgut, undetermined), disease extent (limited disease, metastases, primary tumour and metastases) and functionality (secretory, nonsecretory).

Results

SRS was positive in 107 (89%) patients; CgA levels were increased in 95 (79%) patients. Overall, concordance between SRS and CgA results was found in 84 patients. Positive SRS but normal CgA level were found in 24 patients, with higher prevalence (p < 0.05) in patients with nonsecretory tumours. Conversely, negative SRS but CgA level increased were seen in 12 patients, with higher proportion (p < 0.05) in patients with PDNECs and tumours of hindgut origin.

Conclusions

Overall, 111In-DOTA-TOC SRS proved to be more sensitive than CgA in NETs patients. Tumour differentiation, disease extent and presence of liver metastases impact both SRS and CgA results, whereas nonsecretory activity is a negative predictor of only CgA increase. PDNECs and hindgut origin of tumours predispose to discrepancies with negative SRS but increased CgA levels.

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
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Plöckinger U, Rindi G, Arnold R, Eriksson B, Krenning EP, de Herder WW, et al. Guidelines for the diagnosis and treatment of neuroendocrine gastrointestinal tumours. A consensus statement on behalf of the European Neuroendocrine Tumour Society (ENETS). Neuroendocrinology 2004;80:394–424.

    Article  PubMed  CAS  Google Scholar 

  2. Solcia E, Klöppel G, Sobin LH, Capella C, DeLellis RA, Heitz PU, et al. Histological typing of endocrine tumours: WHO international histological classification of tumours. 2nd ed. Berlin: Springer; 2000.

    Google Scholar 

  3. Papadogias D, Makras P, Griniatsos I, Kaltsas G, Grossman A. Advances in the detection and management of neuroendocrine (carcinoid and pancreatic islet cell) tumours. Curr Opin Endocrinol Diabetes 2006;13:356–61.

    Article  CAS  Google Scholar 

  4. Peracchi M, Conte D, Gebbia C, Penati C, Pizzinelli S, Arosio M, et al. Plasma chromogranin A in patients with sporadic gastro-entero-pancreatic neuroendocrine tumors or multiple endocrine neoplasia type 1. Eur J Endocrinology 2003;148:39–43.

    Article  CAS  Google Scholar 

  5. Ramage JK, Davies AHG, Ardill J, Bax N, Caplin M, Grossman A, et al. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours. Gut 2005;54:1–16.

    Article  Google Scholar 

  6. 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;20:716–31.

    Article  PubMed  CAS  Google Scholar 

  7. Rufini V, Calcagni M, Baum R. Imaging of neuroendocrine tumors. Semin Nucl Med 2006;36:228–47.

    Article  PubMed  Google Scholar 

  8. Deftos LJ. Chromogranin A: its role in endocrine function and as an endocrine and neuroendocrine tumor marker. Endocrine Reviews 1991;12:181–7.

    PubMed  CAS  Google Scholar 

  9. Ricke J, Klose KJ, Mignon M, Oberg 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 

  10. Janson ET, Stridsberg M, Gobl A, Westlin JE, Oberg K. Determination of somatostatin receptor subtype 2 in carcinoid tumors by immunohistochemical investigation with somatostatin receptor subtype 2 antibodies. Cancer Res 1998;58:2375–8.

    PubMed  CAS  Google Scholar 

  11. Papotti M, Croce S, Macri L, Funaro A, Pecchioni C, Schindler M, et al. Correlative immunohistochemical and reverse transcriptase polymerase chain reaction analysis of somatostatin receptor type 2 in neuroendocrine tumors of the lung. Diagn Mol Pathol 2000;9:47–57.

    Article  PubMed  CAS  Google Scholar 

  12. Reubi JC, Waser B, Schaer JC, Laissue JA. Somatostatin receptor sst1-sst5 expression in normal and neoplastic human tissues using receptor autoradiography with subtype-selective ligands. Eur J Nucl Med 2001;28:836–46.

    Article  PubMed  CAS  Google Scholar 

  13. Reubi JC, Schaer JC, Waser B, Wenger S, Heppeler A, Schmitt JS, et al. Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med 2000;27:273–82.

    Article  PubMed  CAS  Google Scholar 

  14. Kwekkeboom D, Krenning EP, de Jong M. Peptide receptor imaging and therapy. J Nucl Med 2000;41:1704–13.

    PubMed  CAS  Google Scholar 

  15. Virgolini I, Patri P, Novotny C, Traub T, Leimer M, Füger B, et al. Comparative somatostatin receptor scintigraphy using In-111-DOTA-lanreotide and In-111-DOTA-Tyr3-octreotide versus F-18-FDG-PET for evaluation of somatostatin receptor-mediated radionuclide therapy. Ann Oncol 2001;12 suppl. 2:41–5.

    Article  Google Scholar 

  16. Rodrigues M, Traub-Weidinger T, Li S, Ibi B, Virgolini I. Comparison of 111In-DOTA-DPhe1-Tyr3-octreotide and 111In-DOTA-lanreotide scintigraphy and dosimetry in patients with neuroendocrine tumours. Eur J Nucl Med 2006;33:532–40.

    Article  Google Scholar 

  17. Stridsberg M, Eriksson B, Oberg K, Janson ET. A comparison between three commercial kits for chromogranin A measurements. J Endocrin 2003;177:337–41.

    Article  CAS  Google Scholar 

  18. Cimitan M, Buonadonna A, Cannizzaro R, Canzonieri V, Borsatti E, Ruffo R, et al. Somatostatin receptor scintigraphy versus chromogranin A assay in the management of patients with neuroendocrine tumors of different types: clinical role. Ann Oncol 2003;14:1135–41.

    Article  PubMed  CAS  Google Scholar 

  19. Reubi JC, Kvols LK, Waser B. Detection of somatostatin receptors in surgical and percutaneous needle biopsy samples of carcinoids and islet cell carcinomas. Cancer Res 1990;50:5969–77.

    PubMed  CAS  Google Scholar 

  20. Rodrigues M, Traub-Weidinger T, Leimer M, Li S, Andreae F, Angelberger P, et al. Value of 111In-DOTA-lanreotide and 111In-DOTA-DPhe1-Tyr3-octreotide in differentiated thyroid cancer: results of in vitro binding studies and in vivo comparison with 18F-FDG PET. Eur J Nucl Med Mol Imaging 2005;32:1144–51.

    Article  PubMed  CAS  Google Scholar 

  21. Stivanello M, Berruti A, Torta M, Termine A, Tampellini M, Gorzegno G, et al. Circulating chromogranin A in the assessment of patients with neuroendocrine tumours. A single institution experience. Ann Oncol 2001;12:73–7.

    Article  Google Scholar 

  22. Öberg K, Stridsberg M. Chromogranins as diagnostic and prognostic markers in neuroendocrine tumors. Adv Exp Med Biol 2000;482:329–37.

    Article  PubMed  Google Scholar 

  23. Seregni E, Ferrari L, Bajetta E, Martinetti A, Bombardieri E. Clinical significance of blood chromogranin A measurement in neuroendocrine tumours. Ann Oncol 2001;12:69–72.

    Article  Google Scholar 

Download references

Acknowledgements

We are grateful to all technologists involved in the acquisition and processing of scintigraphic data and in the measurement of CgA.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Margarida Rodrigues, Michael Gabriel, Dirk Heute, Daniel Putzer & Irene Virgolini

  2. Institute of Nuclear Medicine, Hietzing Hospital, Vienna, Austria

    Margarida Rodrigues

  3. Central Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Innsbruck, Innsbruck, Austria

    Andrea Griesmacher

Authors
  1. Margarida Rodrigues
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Gabriel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dirk Heute
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daniel Putzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andrea Griesmacher
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Irene Virgolini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Margarida Rodrigues.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rodrigues, M., Gabriel, M., Heute, D. et al. Concordance between results of somatostatin receptor scintigraphy with 111In-DOTA-DPhe1-Tyr3-octreotide and chromogranin A assay in patients with neuroendocrine tumours. Eur J Nucl Med Mol Imaging 35, 1796–1802 (2008). https://doi.org/10.1007/s00259-008-0794-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-008-0794-1

Keywords

Search

Navigation