Functional imaging of neuroendocrine tumors: a head-to-head comparison of somatostatin receptor scintigraphy, 123I-MIBG scintigraphy, and 18F-FDG PET

Tina Binderup; Ulrich Knigge; Annika Loft; Jann Mortensen; Andreas Pfeifer; Birgitte Federspiel; Carsten Palnaes Hansen; Liselotte Højgaard; Andreas Kjaer; Tina Binderup; Ulrich Knigge; Annika Loft Jakobsen; Jann Mortensen; Andreas Pfeifer; Birgitte Hartnack Federspiel; Carsten Palnaes Hansen; Liselotte Højgaard; Andreas Kjær

doi:10.2967/jnumed.109.069765

Functional imaging of neuroendocrine tumors: a head-to-head comparison of somatostatin receptor scintigraphy, 123I-MIBG scintigraphy, and 18F-FDG PET

Tina Binderup, Ulrich Knigge, Annika Loft, Jann Mortensen, Andreas Pfeifer, Birgitte Federspiel, Carsten Palnaes Hansen, Liselotte Højgaard, Andreas Kjaer, Tina Binderup, Ulrich Knigge, Annika Loft Jakobsen, Jann Mortensen, Andreas Pfeifer, Birgitte Hartnack Federspiel, Carsten Palnaes Hansen, Liselotte Højgaard, Andreas Kjær

Department of Clinical Medicine

190 Citations (Scopus)

Abstract

Functional techniques are playing a pivotal role in the imaging of cancer today. Our aim was to compare, on a head-to-head basis, 3 functional imaging techniques in patients with histologically verified neuroendocrine tumors: somatostatin receptor scintigraphy (SRS) with (111)In-diethylenetriaminepentaacetic acid-octreotide, scintigraphy with (123)I-metaiodobenzylguanidine (MIBG), and (18)F-FDG PET. METHODS: Ninety-six prospectively enrolled patients with neuroendocrine tumors underwent SRS, (123)I-MIBG scintigraphy, and (18)F-FDG PET on average within 40 d. The functional images were fused with low-dose CT scans for anatomic localization, and the imaging results were compared with the proliferation index as determined by Ki67. RESULTS: The overall sensitivity of SRS, (123)I-MIBG scintigraphy, and (18)F-FDG PET was 89%, 52%, and 58%, respectively. Of the 11 SRS-negative patients, 7 were (18)F-FDG PET-positive, of which 3 were also (123)I-MIBG scintigraphy-positive, giving a combined overall sensitivity of 96%. SRS also exceeded (123)I-MIBG scintigraphy and (18)F-FDG PET based on the number of lesions detected (393, 185, and 225, respectively) and tumor subtypes. (123)I-MIBG scintigraphy was superior to (18)F-FDG PET for ileal neuroendocrine tumors, and (18)F-FDG PET was superior to (123)I-MIBG scintigraphy for pancreaticoduodenal neuroendocrine tumors. The sensitivity of (18)F-FDG PET (92%) exceeded that of both SRS (69%) and (123)I-MIBG scintigraphy (46%) for tumors with a proliferation index above 15%. CONCLUSION: The overall sensitivity of (123)I-MIBG scintigraphy and (18)F-FDG PET was low compared with SRS. However, for tumors with a high proliferation rate, (18)F-FDG PET had the highest sensitivity. The results indicate that, although SRS should still be the routine method, (18)F-FDG PET provides complementary diagnostic information and is of value for neuroendocrine tumor patients with negative SRS findings or a high proliferation index.

Original language	English
Journal	Journal of Nuclear Medicine
Volume	51
Issue number	5
Pages (from-to)	704-12
Number of pages	9
ISSN	0161-5505
DOIs	https://doi.org/10.2967/jnumed.109.069765
Publication status	Published - 1 May 2010

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.2967/jnumed.109.069765

Cite this

Binderup, T., Knigge, U., Loft, A., Mortensen, J., Pfeifer, A., Federspiel, B., Hansen, C. P., Højgaard, L., Kjaer, A., Binderup, T., Knigge, U., Jakobsen, A. L., Mortensen, J., Pfeifer, A., Federspiel, B. H., Hansen, C. P., Højgaard, L., & Kjær, A. (2010). Functional imaging of neuroendocrine tumors: a head-to-head comparison of somatostatin receptor scintigraphy, 123I-MIBG scintigraphy, and 18F-FDG PET. Journal of Nuclear Medicine, 51(5), 704-12. https://doi.org/10.2967/jnumed.109.069765

Binderup, T , Knigge, U, Loft, A, Mortensen, J, Pfeifer, A, Federspiel, B, Hansen, CP, Højgaard, L , Kjaer, A, Binderup, T, Knigge, U, Jakobsen, AL, Mortensen, J, Pfeifer, A, Federspiel, BH, Hansen, CP, Højgaard, L & Kjær, A 2010, 'Functional imaging of neuroendocrine tumors: a head-to-head comparison of somatostatin receptor scintigraphy, 123I-MIBG scintigraphy, and 18F-FDG PET', Journal of Nuclear Medicine, vol. 51, no. 5, pp. 704-12. https://doi.org/10.2967/jnumed.109.069765

@article{973b9d905fff11df928f000ea68e967b,

title = "Functional imaging of neuroendocrine tumors: a head-to-head comparison of somatostatin receptor scintigraphy, 123I-MIBG scintigraphy, and 18F-FDG PET",

abstract = "Functional techniques are playing a pivotal role in the imaging of cancer today. Our aim was to compare, on a head-to-head basis, 3 functional imaging techniques in patients with histologically verified neuroendocrine tumors: somatostatin receptor scintigraphy (SRS) with (111)In-diethylenetriaminepentaacetic acid-octreotide, scintigraphy with (123)I-metaiodobenzylguanidine (MIBG), and (18)F-FDG PET. METHODS: Ninety-six prospectively enrolled patients with neuroendocrine tumors underwent SRS, (123)I-MIBG scintigraphy, and (18)F-FDG PET on average within 40 d. The functional images were fused with low-dose CT scans for anatomic localization, and the imaging results were compared with the proliferation index as determined by Ki67. RESULTS: The overall sensitivity of SRS, (123)I-MIBG scintigraphy, and (18)F-FDG PET was 89%, 52%, and 58%, respectively. Of the 11 SRS-negative patients, 7 were (18)F-FDG PET-positive, of which 3 were also (123)I-MIBG scintigraphy-positive, giving a combined overall sensitivity of 96%. SRS also exceeded (123)I-MIBG scintigraphy and (18)F-FDG PET based on the number of lesions detected (393, 185, and 225, respectively) and tumor subtypes. (123)I-MIBG scintigraphy was superior to (18)F-FDG PET for ileal neuroendocrine tumors, and (18)F-FDG PET was superior to (123)I-MIBG scintigraphy for pancreaticoduodenal neuroendocrine tumors. The sensitivity of (18)F-FDG PET (92%) exceeded that of both SRS (69%) and (123)I-MIBG scintigraphy (46%) for tumors with a proliferation index above 15%. CONCLUSION: The overall sensitivity of (123)I-MIBG scintigraphy and (18)F-FDG PET was low compared with SRS. However, for tumors with a high proliferation rate, (18)F-FDG PET had the highest sensitivity. The results indicate that, although SRS should still be the routine method, (18)F-FDG PET provides complementary diagnostic information and is of value for neuroendocrine tumor patients with negative SRS findings or a high proliferation index.",

author = "Tina Binderup and Ulrich Knigge and Annika Loft and Jann Mortensen and Andreas Pfeifer and Birgitte Federspiel and Hansen, {Carsten Palnaes} and Liselotte H{\o}jgaard and Andreas Kjaer and Tina Binderup and Ulrich Knigge and Jakobsen, {Annika Loft} and Jann Mortensen and Andreas Pfeifer and Federspiel, {Birgitte Hartnack} and Hansen, {Carsten Palnaes} and Liselotte H{\o}jgaard and Andreas Kj{\ae}r",

year = "2010",

month = may,

day = "1",

doi = "10.2967/jnumed.109.069765",

language = "English",

volume = "51",

pages = "704--12",

journal = "The Journal of Nuclear Medicine",

issn = "0161-5505",

publisher = "Society of Nuclear Medicine",

number = "5",

}

TY - JOUR

T1 - Functional imaging of neuroendocrine tumors: a head-to-head comparison of somatostatin receptor scintigraphy, 123I-MIBG scintigraphy, and 18F-FDG PET

AU - Binderup, Tina

AU - Knigge, Ulrich

AU - Loft, Annika

AU - Mortensen, Jann

AU - Pfeifer, Andreas

AU - Federspiel, Birgitte

AU - Hansen, Carsten Palnaes

AU - Højgaard, Liselotte

AU - Kjaer, Andreas

AU - Binderup, Tina

AU - Knigge, Ulrich

AU - Jakobsen, Annika Loft

AU - Mortensen, Jann

AU - Pfeifer, Andreas

AU - Federspiel, Birgitte Hartnack

AU - Hansen, Carsten Palnaes

AU - Højgaard, Liselotte

AU - Kjær, Andreas

PY - 2010/5/1

Y1 - 2010/5/1

N2 - Functional techniques are playing a pivotal role in the imaging of cancer today. Our aim was to compare, on a head-to-head basis, 3 functional imaging techniques in patients with histologically verified neuroendocrine tumors: somatostatin receptor scintigraphy (SRS) with (111)In-diethylenetriaminepentaacetic acid-octreotide, scintigraphy with (123)I-metaiodobenzylguanidine (MIBG), and (18)F-FDG PET. METHODS: Ninety-six prospectively enrolled patients with neuroendocrine tumors underwent SRS, (123)I-MIBG scintigraphy, and (18)F-FDG PET on average within 40 d. The functional images were fused with low-dose CT scans for anatomic localization, and the imaging results were compared with the proliferation index as determined by Ki67. RESULTS: The overall sensitivity of SRS, (123)I-MIBG scintigraphy, and (18)F-FDG PET was 89%, 52%, and 58%, respectively. Of the 11 SRS-negative patients, 7 were (18)F-FDG PET-positive, of which 3 were also (123)I-MIBG scintigraphy-positive, giving a combined overall sensitivity of 96%. SRS also exceeded (123)I-MIBG scintigraphy and (18)F-FDG PET based on the number of lesions detected (393, 185, and 225, respectively) and tumor subtypes. (123)I-MIBG scintigraphy was superior to (18)F-FDG PET for ileal neuroendocrine tumors, and (18)F-FDG PET was superior to (123)I-MIBG scintigraphy for pancreaticoduodenal neuroendocrine tumors. The sensitivity of (18)F-FDG PET (92%) exceeded that of both SRS (69%) and (123)I-MIBG scintigraphy (46%) for tumors with a proliferation index above 15%. CONCLUSION: The overall sensitivity of (123)I-MIBG scintigraphy and (18)F-FDG PET was low compared with SRS. However, for tumors with a high proliferation rate, (18)F-FDG PET had the highest sensitivity. The results indicate that, although SRS should still be the routine method, (18)F-FDG PET provides complementary diagnostic information and is of value for neuroendocrine tumor patients with negative SRS findings or a high proliferation index.

AB - Functional techniques are playing a pivotal role in the imaging of cancer today. Our aim was to compare, on a head-to-head basis, 3 functional imaging techniques in patients with histologically verified neuroendocrine tumors: somatostatin receptor scintigraphy (SRS) with (111)In-diethylenetriaminepentaacetic acid-octreotide, scintigraphy with (123)I-metaiodobenzylguanidine (MIBG), and (18)F-FDG PET. METHODS: Ninety-six prospectively enrolled patients with neuroendocrine tumors underwent SRS, (123)I-MIBG scintigraphy, and (18)F-FDG PET on average within 40 d. The functional images were fused with low-dose CT scans for anatomic localization, and the imaging results were compared with the proliferation index as determined by Ki67. RESULTS: The overall sensitivity of SRS, (123)I-MIBG scintigraphy, and (18)F-FDG PET was 89%, 52%, and 58%, respectively. Of the 11 SRS-negative patients, 7 were (18)F-FDG PET-positive, of which 3 were also (123)I-MIBG scintigraphy-positive, giving a combined overall sensitivity of 96%. SRS also exceeded (123)I-MIBG scintigraphy and (18)F-FDG PET based on the number of lesions detected (393, 185, and 225, respectively) and tumor subtypes. (123)I-MIBG scintigraphy was superior to (18)F-FDG PET for ileal neuroendocrine tumors, and (18)F-FDG PET was superior to (123)I-MIBG scintigraphy for pancreaticoduodenal neuroendocrine tumors. The sensitivity of (18)F-FDG PET (92%) exceeded that of both SRS (69%) and (123)I-MIBG scintigraphy (46%) for tumors with a proliferation index above 15%. CONCLUSION: The overall sensitivity of (123)I-MIBG scintigraphy and (18)F-FDG PET was low compared with SRS. However, for tumors with a high proliferation rate, (18)F-FDG PET had the highest sensitivity. The results indicate that, although SRS should still be the routine method, (18)F-FDG PET provides complementary diagnostic information and is of value for neuroendocrine tumor patients with negative SRS findings or a high proliferation index.

U2 - 10.2967/jnumed.109.069765

DO - 10.2967/jnumed.109.069765

M3 - Journal article

C2 - 20395333

SN - 0161-5505

VL - 51

SP - 704

EP - 712

JO - The Journal of Nuclear Medicine

JF - The Journal of Nuclear Medicine

IS - 5

ER -

Functional imaging of neuroendocrine tumors: a head-to-head comparison of somatostatin receptor scintigraphy, 123I-MIBG scintigraphy, and 18F-FDG PET

Abstract

UN SDGs

Access to Document

Fingerprint

Cite this