Joint Program in Nuclear Medicine

Octreotide Imaging

Kee Young Wee, MD
Scott Britz-Cunningham, MD

September 19, 2000

Presentation

Imaging Technique

Imaging Findings

Indium-111 Pentetreotide imaging at 24 hours showed a large right suprarenal lesion with peripheral uptake and a relatively photopenic center (shown by arrows). SPECT imaging in the axial, sagital and coronal planes confirmed the findings of a right suprarenal lesion with a photopenic center. Intense activity is seen in the kidneys and bladder (B) with less intense uptake in the liver and the spleen (S). The were no additional lesions identified.

Follow Up

Surgical resection was performed. Pathology revealed 16 cm mass which was largely cystic without necrosis or invasion. Diagnosis - right adrenal pheochromocytoma.

Discussion

Somatostatin is a naturally occurring neuropeptide. It functions as a neurotransmitter in the central nervous system. It inhibits release of Somatostatin receptors are found normally in the Somatostatin receptors are found in many tumors including Also, somatostatin receptors are found in Indium-111 Pentetreotide is a cyclic octapeptide analog of somatostatin. DTPA allows labeling with In-111. Excreted primarily by the renal system. In-111 pentetreotide imaging is a sensitive method for detecting presence of tumors such as glucagonomas, vipomas, carcinoids, nonfunctioning islet cell tumors. When used as a complementary study to conventional methods, additional tumor sites can be localized which can alter patient management.

References

1. Krenning E, Kwekkeboom D, et al. Somatostatin receptor scintigraphy with In-111 DTPA D Phe and I-123 Tyr 3 Octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med 1993;20:716-731.

2. Murray IP, Ell PJ, Nuclear Medicine in Clinical Diagnosis and Treatment, Churchill Livingstone, Second Edition, p. 859-870 and p. 1001-1009.

3. Coel M, Leung M, Atlas of Nuclear Medicine, W.B. Saunders Company, 1996, p. 696-697

4. Krenning E, Kwekkeboom D, et al., Somatostatin Receptor Scintigraphy, Nuclear Medicine Annual 1995.

5. Somatostatin Receptor Imaging for Neuroendocrine Tumors: Product Monograph/OctreoScan, Mallinckrodt Medical, Inc. 1994.

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J. Anthony Parker, MD PhD, Tony_Parker@CareGroup.Harvard.edu