^(99m)Tc-HYNIC-TOC生长抑素受体显像诊断胰腺神经内分泌肿瘤的临床应用

Clinical Application of Somatostatin Receptor Imaging with ^(99m)Tc-HYNIC-TOC in the Diagnosis of Pancreatic Neuroendocrine Tumors

背景:传统的影像学检查方法(如CT、MRI)在胰腺神经内分泌肿瘤定位和分期中的价值有限。神经内分泌肿瘤表达生长抑素受体,因此应用放射性核素标记的生长抑素类似物能进行肿瘤显像。目的:评价99mTc-HYNIC-TOC生长抑素受体显像诊断和定位胰腺神经内分泌肿瘤的临床价值。方法:37例临床确诊或怀疑胰腺神经内分泌肿瘤患者行99mTc-HYNIC-TOC生长抑素受体显像,其中胰岛素瘤18例,胃泌素瘤4例,胰高血糖素瘤4例,未分类的胰腺神经内分泌肿瘤11例。静脉注射99mTc-HYNIC-TOC350～400MBq后1、4h行全身显像,部分阳性区域行局部显像或单光子发射计算体层摄影(SPECT)/CT。结果:37例患者中99mTc-HYNIC-TOC显像阳性27例,其中胰岛素瘤9例,胃泌素瘤4例,胰高血糖素瘤3例,未分类的胰腺神经内分泌肿瘤11例。99mTc-HYNIC-TOC显像诊断胰腺神经内分泌肿瘤的检出率为73.0%。99mTc-HYNIC-TOC显像改变了6例患者的肿瘤分期,并证实了7例患者的治疗效果。结论:99mTc-HYNIC-TOC显像可有效帮助诊断,定位胰腺神经内分泌肿瘤,指导分期,并辅助临床评价各种治疗方法的疗效。

Background： Conventional radiological techniques such as CT and MRI have limitations for localizing and staging pancreatic neuroendocrine tumors. Neuroendocrine tumors express somatostatin receptors, and can be visualized by radionuclide labelled somatostatin analogue scintigraphy. Aims： To assess the clinical value of somatostatin receptor imaging with ^99mTc-HYNIC-TOC （^99mTc-hydrazinonicotinyl-Tyr3-octreotide） in the diagnosis and localization of pancreatic neuroendocrine tumors. Methods： Thirty-seven patients with clinically diagnosed or suspected pancreatic neuroendocrine tumors were enrolled, including 18 insulinomas, 4 gastrinomas, 4 glucagonomas and 11 unclassified pancreatic neuroendocrine tumors. Total body imaging was obtained at 1 and 4 hours after intravenous injection of 350-400 MBq ^99mTc- HYNIC-TOC, and regional or single photo emission computed tomography （SPECT）/CT imaging was performed in some positive cases. Results： Positive findings were obtained in 27 of 37 patients, including 9 insulinomas, 4 gastrinomas, 3 glucagonomas and 11 unclassified pancreatic neuroendocrine tumors. 73.0% of patients with pancreatic neuroendocrine tumors were diagnosed by somatostatin receptor imaging with ^99mTc-HYNIC-TOC, which clarified the staging of tumors in 6 cases, and confirmed the therapeutic effect in 7 cases. Conclusions： ^99mTc-HYNIC-TOC imaging is not only helpful for the diagnosis and localization of pancreatic neuroendocrine tumors, but also useful for disease staging and evaluation of therapeutic response.