Attenuation Correction of Somatostatin Receptor SPECT by Integrated Low-Dose CT

Steffen, Ingo G.; Mehl, Sebastian; Heuck, F; Elgeti, Florian; Furth, Christian; Amthauer, Holger; Ruf, Juri

doi:10.1097/rlu.0b013e3181becfcb

Cited by 12 publications

(4 citation statements)

References 19 publications

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“…The introduction of SPECT/CT for SRS has been of great value in the anatomic assignment of NEN lesions (17)(18)(19) and-because of early implementation of attenuation correction-in the improvement of image quality (20). Not surprisingly, the resulting evolving role of SPECT/CT in the management of NEN tumors has recently been emphasized in a review by Fuccio et al (21).…”

Section: Discussionmentioning

confidence: 99%

Significance of a Single-Time-Point Somatostatin Receptor SPECT/Multiphase CT Protocol in the Diagnostic Work-up of Gastroenteropancreatic Neuroendocrine Neoplasms

et al. 2015

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This prospective study compared a 1-d SPECT/CT protocol with the commonly used 3-d protocol for somatostatin receptor scintigraphy in patients with gastroenteropancreatic neuroendocrine neoplasms. Additionally, the influence of SPECT/CT on patient management was evaluated. Methods: From October 2011 to October 2012, all gastroenteropancreatic neuroendocrine neoplasm patients undergoing restaging with somatostatin receptor scintigraphy on a modern SPECT/CT device were enrolled in this study. The protocol consisted of planar imaging at 4, 24, and 48 h; low-dose SPECT/CT at 24 and 48 h; diagnostic CT at 24 h using a triple-phase delay after administration of contrast; and diagnostic SPECT/CT at 24 h. All components of the imaging data were reassessed by 3 masked interpreters. The results were compared with a reference standard based on all clinical, imaging, and histopathology follow-up data available (follow-up range, 24-36 mo; mean, 29.9 mo). The reference standard was defined by a study-specific interdisciplinary tumor board that also reassessed treatment decisions. Results: Thirty-one patients were eligible for analysis (18 men and 13 women; mean age, 60.4 y). Ten had no imaging signs of disease and remained disease-free during follow-up. Twenty-one had persistent or recurrent disease (82 lesions: 24 in the liver, 21 in the lymph nodes, 16 in bone, 12 in the pancreas, and 9 in other locations). The respective lesion detection rates for interpreters 1, 2, and 3 were 51.9%, 49.4%, and 71.6% for low-dose SPECT/CT at 24 h; 51.9%, 55.6%, and 67.9% for low-dose SPECT/CT at 48 h; 63.0%, 70.4%, and 85.2% for diagnostic CT; and 77.8%, 84.0%, and 88.9% for diagnostic SPECT/CT. Interobserver agreement was moderate for diagnostic SPECT/CT (κ 5 0.44), diagnostic CT (κ 5 0.43), low-dose SPECT/CT at 48 h (κ 5 0.61), and low-dose SPECT/CT at 24 h (κ 5 0.55). For planar imaging, interobserver agreement was fair after 48 h (κ 5 0.36) and 24 h (κ 5 0.38) and moderate after 4 h (κ 5 0.42). Every lesion detectable on planar imaging or lowdose SPECT/CT was also detectable on diagnostic SPECT/CT. The CT and SPECT components of diagnostic SPECT/CT strongly complemented each other, as 34 of 82 lesions (41.4%) were detected on only the CT component or only the SPECT component. Therapeutic management was influenced by the diagnostic SPECT/CT interpretation in 8 of 31 patients (25.8%). Conclusion: The highest detection rates were achieved by diagnostic SPECT/CT. Thus, a more patient-friendly 1-d protocol is feasible. Furthermore, multiphase SPECT/CT affected management in about a quarter of patients.

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Section: Discussionmentioning

confidence: 99%

Significance of a Single-Time-Point Somatostatin Receptor SPECT/Multiphase CT Protocol in the Diagnostic Work-up of Gastroenteropancreatic Neuroendocrine Neoplasms

et al. 2015

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“…As we further explain in the following section, CT coregistration has been reported to improve the localization of the lesions, thanks to the attenuation correction [43][44][45].…”

Section: Somatostatin Receptor Scintigraphic Imagingmentioning

confidence: 99%

Somatostatin receptor SPECT

Pepe

Moncayo

Bombardieri³

et al. 2012

Eur J Nucl Med Mol Imaging

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Somatostatin is a peptide with a broad distribution in the nervous system and acts as a neurotransmitter in several organs, having a wide range of mainly inhibiting effects, such as the suppression of growth hormone release, as well as the inhibition of pancreatic and gastrointestinal hormone release. Five somatostatin receptor subtypes have been cloned and demonstrated to have an emphasized expression in all human tumours. In particular, type 2 receptors were identified as the most frequently represented on the surface of neuroendocrine tumour cells, providing the molecular basis for many clinical applications of somatostatin analogues. Towards the end of the 1980s, the in vivo demonstration of somatostatin receptors on the surface of some tumours raised interest in receptor imaging, and indeed the peptide receptor overexpression on tumour cells, as compared to normal tissues, constitutes the basis for molecular imaging of these tumours. This review intends to illustrate the development of single photon emission radiopharmaceuticals for the study of somatostatin receptors and their application in diagnostic imaging.

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“…The impact of AC by low-dose CT with a hybrid SPECT/CT device on SRS sensitivity was specifically addressed by Steffen et al [37] in a retrospective analysis of 50 consecutive patients with NETs. All the sites of uptake on both the NAC and AC SPECT images were scored for intensity and contrast using a six-point scale.…”

Section: In-111 Pentetreotide Spect/ctmentioning

confidence: 99%

SPECT/CT in neuroendocrine tumours

Schillaci

Spanu

Palumbo

et al. 2014

Clin Transl Imaging

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Neuroendocrine tumours (NETs) are a heterogeneous group of neoplasms with very varying clinical expressions. Nuclear medicine plays an important role in the imaging and treatment of these tumours. Despite the advent of several PET radiopharmaceuticals, SPECT imaging with the labelled somatostatin receptor analogue In-111 pentetreotide or with radioiodinated MIBG is still a very useful technique for evaluating patients with NETs. The aim of this review is to summarise the applications, in the study of NETs, of hybrid SPECT/CT imaging performed using these gamma-emitting radiopharmaceuticals. The combined use of SPECT and CT in hybrid devices is of value when applied to scintigraphic procedures in NETs: the addition of anatomical maps provides a precise localisation of SPECT findings and allows the exclusion of disease in sites of physiological tracer uptake. These advantages translate into better sensitivity and specificity, both of which are essential for the diagnosis and accurate staging of NETs. SPECT/CT hybrid images are able to provide additional information that improves the diagnostic accuracy and confidence of SPECT interpretation and leads to changes in therapeutic options in about 25 % of patients. Therefore, SPECT/CT should be routinely performed and considered standard practice in the diagnostic work-up and treatment planning of patients with NETs submitted to In-111 pentetreotide or radioiodinated MIBG imaging. This approach can still be used as an alternative to PET/CT options when the latter are not available.

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Attenuation Correction of Somatostatin Receptor SPECT by Integrated Low-Dose CT

Abstract: Attenuation correction of somatostatin receptor scintigraphy-SPECT significantly improves focus visualization and, albeit slightly, also significantly increases sensitivity.

Cited by 12 publications

References 19 publications

Significance of a Single-Time-Point Somatostatin Receptor SPECT/Multiphase CT Protocol in the Diagnostic Work-up of Gastroenteropancreatic Neuroendocrine Neoplasms

Significance of a Single-Time-Point Somatostatin Receptor SPECT/Multiphase CT Protocol in the Diagnostic Work-up of Gastroenteropancreatic Neuroendocrine Neoplasms

Somatostatin receptor SPECT

SPECT/CT in neuroendocrine tumours

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