Dual tracer hybrid radionuclide imaging of a metastatic gastrointestinal neuroendocrine tumor with unknown primary site using 18F-FDG PET/CT and 99mTc-HYNIC-TOC SPECT/CT (case report and literature review)
A. V. Leontyev,
N. A. Rubtsova,
A. I. Khalimon,
T. L. Antonevskaya,
M. T. Kuliev,
A. V. Levshakova,
I. V. Pylova,
T. N. Lazutina,
A. D. Kaprin https://doi.org/10.24835/1607-0763-927
Abstract
Neuroendocrine tumors (NEТ) are a heterogeneous group of neoplasms of various locations originating from the APUD system cells with biologically active properties. Although immunohistochemical assay for Ki-67 has been proved to have prognostic significance in GEP-NENs, pitfalls may lead to misjudgment of the tumor grades, prognosis and during treatment planning due to the presence of cells with varying degrees of differentiation and proliferative activity within a single lesion, as well as the entire neoplastic process. These features can affect the results of imaging and therapy planning.
An increase in the number of somatostatin receptors on the surface of membrane cells, as well as an increase in glycolysis may occur in NETs. These phenomena play role when choosing imaging methods, as well as in treatment planning.
Combined dual-tracer imaging, specifically PET/CT or SPECT/CT using labeled somatostatin analogues can be used in intermediate assessment of cellular heterogeneity in the entire neoplastic process in NENs and help to minimize diagnostic pitfalls listed above.
We present an observation of a patient with metastatic GEP-NEN of unknown primary in which 18F-FDG PET/CT and 99mTc-HYNIC-TOC SPECT/CT were performed for initial staging. In the framework of this, aspects of use of dual-tracer radionuclide imaging in patients with NENs are widely discussed.
About the Authors
A. V. Leontyev
P. Hertsen Moscow oncology research institute, Branch of National Medical Research Radiological Centre of the Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Alexey V. Leontyev, Cand. of Sci. (Med.), Head of Nuclear Medicine Department
3, 2nd Botlinsky proezd, Moscow, 125284
Competing Interests:
The authors declare no conflict of interest. The study had no sponsorship.
N. A. Rubtsova
P. Hertsen Moscow oncology research institute, Branch of National Medical Research Radiological Centre of the Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Natalia A. Rubtsova, Doct. of Sci. (Med.), Head of Radiology Department
3, 2nd Botlinsky proezd, Moscow, 125284
Competing Interests:
The authors declare no conflict of interest. The study had no sponsorship.
A. I. Khalimon
P. Hertsen Moscow oncology research institute, Branch of National Medical Research Radiological Centre of the Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Alexander I. Khalimon, radiologist of CT and MRI Department
3, 2nd Botlinsky proezd, Moscow, 125284
Competing Interests:
The authors declare no conflict of interest. The study had no sponsorship.
T. L. Antonevskaya
P. Hertsen Moscow oncology research institute, Branch of National Medical Research Radiological Centre of the Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Tamara L. Antonevskaya, Resident of Oncology, Radiotherapy and Plastic Surgery Department
3, 2nd Botlinsky proezd, Moscow, 125284
Competing Interests:
The authors declare no conflict of interest. The study had no sponsorship.
M. T. Kuliev
P. Hertsen Moscow oncology research institute, Branch of National Medical Research Radiological Centre of the Ministry of Health of Russia
Competing Interests:
Magomed T. Kuliev, nuclear medicine physician of Nuclear Medicine Department
3, 2nd Botlinsky proezd, Moscow, 125284
Competing Interests:
The authors declare no conflict of interest. The study had no sponsorship.
A. V. Levshakova
P. Hertsen Moscow oncology research institute, Branch of National Medical Research Radiological Centre of the Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Antonina V. Levshakova, Doct. of Sci. (Med.), Head of CT & MRI Department
3, 2nd Botlinsky proezd, Moscow, 125284
Competing Interests:
The authors declare no conflict of interest. The study had no sponsorship.
I. V. Pylova
P. Hertsen Moscow oncology research institute, Branch of National Medical Research Radiological Centre of the Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Irina V. Pylova, Cand. of Sci. (Med.), nuclear medicine physician of Nuclear Medicine Department
3, 2nd Botlinsky proezd, Moscow, 125284
Competing Interests:
The authors declare no conflict of interest. The study had no sponsorship.
T. N. Lazutina
P. Hertsen Moscow oncology research institute, Branch of National Medical Research Radiological Centre of the Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Tatyana N. Lazutina, Cand. of Sci. (Med.), nuclear medicine physician of Nuclear Medicine Department
3, 2nd Botlinsky proezd, Moscow, 125284
Competing Interests:
The authors declare no conflict of interest. The study had no sponsorship.
A. D. Kaprin
P. Hertsen Moscow oncology research institute, Branch of National Medical Research Radiological Centre of the Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Andrey D. Kaprin, Academician of the Russian Academy of Sciences, Corresponding member of Russian Academy of Education, Doct. of Sci. (Med.), Professor, Honored Doctor of the Russian Federation, Chief urologist of the Russian Academy of Sciences, General Director of “National Medical Radiological Research Center” of the Ministry of Health of the Russian Federation (3, 2nd Botlinsky proezd, Moscow, 125284), Head of Department of urology and surgical nephrology with a course of oncourology at the medical faculty of medical institute of The Peoples' Friendship University of Russia
Competing Interests:
The authors declare no conflict of interest. The study had no sponsorship.
References
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For citations:
Leontyev A.V., Rubtsova N.A., Khalimon A.I., Antonevskaya T.L., Kuliev M.T., Levshakova A.V., Pylova I.V., Lazutina T.N., Kaprin A.D. Dual tracer hybrid radionuclide imaging of a metastatic gastrointestinal neuroendocrine tumor with unknown primary site using 18F-FDG PET/CT and 99mTc-HYNIC-TOC SPECT/CT (case report and literature review). Medical Visualization. 2021;25(2):90-97. (In Russ.) https://doi.org/10.24835/1607-0763-927
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