Intraoperative detection of somatostatin-receptor-positive neuroendocrine tumours using indium-111-labelled DTPA-D-Phe1-octreotide

• Published in: British journal of cancer 1996-03, Vol.73 (6), p.770-775
• Main Authors: Wangberg, B, Forssell-Aronsson, E, Tisell, L-E, Nilsson, O, Fjalling, M, Ahlman, H
• Format: Article
• Language: English
• Subjects: analogs & derivatives; analysis; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer and Oncology; Cancer och onkologi; Cancer Research; Carcinoid Tumor; Carcinoid Tumor - diagnostic imaging; Carcinoid Tumor - surgery; Carcinoid Tumor - ultrastructure; diagnostic use; Drug Resistance; Epidemiology; experimental-oncology; Female; Gastroenterologi; Gastroenterology and Hepatology; Humans; Indium Radioisotopes; Intraoperative Care; Investigative techniques, diagnostic techniques (general aspects); Kirurgi; Medical sciences; Miscellaneous. Technology; Molecular Medicine; Neuroendocrine Tumors; Neuroendocrine Tumors - diagnostic imaging; Neuroendocrine Tumors - surgery; Neuroendocrine Tumors - ultrastructure; Octreotide; Octreotide - analogs & derivatives; Oncology; Pancreatic Neoplasms; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - surgery; Pancreatic Neoplasms - ultrastructure; Pentetic Acid; Pentetic Acid - analogs & derivatives; Radiologi och bildbehandling; Radiology, Nuclear Medicine and Medical Imaging; Radionuclide Imaging; Radionuclide investigations; Receptors; Receptors, Somatostatin - analysis; Somatostatin; Stomach Neoplasms; Stomach Neoplasms - diagnostic imaging; Stomach Neoplasms - surgery; Stomach Neoplasms - ultrastructure; Surgery; Thyroid Neoplasms; Thyroid Neoplasms - diagnostic imaging; Thyroid Neoplasms - surgery; Thyroid Neoplasms - ultrastructure; ultrastructure; Uterine Cervical Neoplasms; Uterine Cervical Neoplasms - diagnostic imaging; Uterine Cervical Neoplasms - surgery; Uterine Cervical Neoplasms - ultrastructure
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.1996.134

After injection of 111In-labelled DTPA-D-Phe1-octreotide, intraoperative tumour localisation was performed using a scintillation detector in 23 patients with neuroendocrine tumours. Count rates from suspect tumour lesions and adjacent normal tissue were expressed as a ratio before (Rin situ) and after (Rex vivo) excision. 111In activity concentration ratios of tumour tissue to blood (T/B) were determined in a gamma counter. In patients with midgut carcinoids, (all scintigraphy positive), false Rin situ recordings were found in 4/29 macroscopically identified tumours. T/B ratios were all high (27-650). In patients with medullary thyroid carcinomas (eight out of ten scintigraphy positive), misleading Rin situ results were found in 4/37 macroscopically identified tumours. T/B ratios were lower (3-39) than those seen in midgut carcinoids. Two out of four patients with endocrine pancreatic tumours had positive scintigraphy, reliable intraoperative measurements and very high T/B ratios (910-1500). One patient with a gastric carcinoid had correct measurements in situ and ex vivo with high T/B ratios (71-210). In situ measurements added little information to preoperative scintigraphy and surgical findings using the present detection system. Rex vivo measurements were more reliable. The very high T/B ratios seen in midgut carcinoids and some endocrine pancreatic tumours would be favourable for future radiation therapy via somatostatin receptors.