Clinical application of 99mTc-HYNIC-TOC SPECT/CT in diagnosing and monitoring of pancreatic neuroendocrine neoplasms

Ann Nucl Med. 2018 Aug;32(7):446-452. doi: 10.1007/s12149-018-1266-8. Epub 2018 Jun 20.

Abstract

Objective: Our aim of this research was to determine the value of SPECT/CT with 99mTc-HYNIC-TOC for evaluation of the pancreatic masses which were suspected as neuroendocrine neoplasms and follow-up of patients with pancreatic neuroendocrine neoplasms.

Methods: We retrospectively analyzed 184 patients who performed 99mTc-HYNIC-TOC SPECT/CT. All the patients were divided into two groups: one for assessment of diagnostic efficiency for pancreatic suspected masses (n = 140) and another for monitoring recurrence after surgery (n = 44). The image findings acquired at 2 h postinjection were compared to final diagnoses from pathological results and clinical follow-up. Then, the correlation between ratios of tumor-to-background (TBR) and tumor grade was analyzed.

Results: In group 1, 95/140 (67.9%) patients were confirmed as neuroendocrine neoplasms including 85 neuroendocrine tumors and 10 neuroendocrine carcinomas. Patient-based analysis showed that the sensitivity, specificity and accuracy of diagnosing neuroendocrine neoplasms with SPECT/CT were 81.1, 84.4 and 82.1%. There was significant difference of TBRs among G1, G2 and G3 (F = 3.175, P = 0.048). In group 2, 22/44 (50.0%) patients occurred metastasis mainly in liver. The sensitivity, specificity and accuracy of monitoring recurrence were 87.0, 100 and 93.2%.

Conclusions: 99mTc-HYNIC-TOC SPECT/CT is a reliable method of diagnosing and monitoring of pancreatic neuroendocrine neoplasms, especially neuroendocrine tumors.

Keywords: 99mTc-HYNIC-TOC; Pancreatic neuroendocrine neoplasm; Ratios of tumor-to-background; SPECT/CT.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / diagnostic imaging*
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / surgery
  • Octreotide / analogs & derivatives*
  • Organotechnetium Compounds*
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Recurrence
  • Retrospective Studies
  • Signal-To-Noise Ratio
  • Single Photon Emission Computed Tomography Computed Tomography*
  • Young Adult

Substances

  • Organotechnetium Compounds
  • technetium Tc 99m hydrazinonicotinyl-Tyr(3)-octreotide
  • Octreotide