RESEARCH PAPER
Diagnostic and prognostic value of 99mTc-Tektrotyd
scintigraphy and 18F-FDG PET/CT in a single-center
cohort of neuroendocrine tumors
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1 |
Center for Nuclear Medicine and PET, University Clinical Center of Serbia, Belgrade, Serbia |
2 |
Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center
of Serbia, Belgrade, Serbia |
3 |
Faculty of Medicine, University of Belgrade, Serbia |
4 |
Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade,
Serbia |
CORRESPONDING AUTHOR
Jelena Saponjski
Centar for Nuclear Medicine and PET, Clinical Center of Serbia, Belgrade, Serbia, Serbia
Submission date: 2020-08-21
Final revision date: 2020-11-13
Acceptance date: 2020-11-29
Online publication date: 2021-03-18
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The aim was to assess the diagnostic value of 99mTc-Tektrotyd scintigraphy (TCT) and positron emission tomography/computed tomography using F-18 fluorodeoxyglucose (18F-FDG PET/CT) in the detection and
follow-up of neuroendocrine tumors (NETs), and their predictive value for
disease progression.
Material and methods:
In this retrospective cohort, TCT and 18F-FDG PET/CT
were performed in 90 patients (37 men, 53 women, mean age 52.7 ±15.1), with
NET. Correlation of Ki67 and tumor grade versus Krenning score and SUVmax
was assessed, Kaplan-Meier analysis was used for progression-free survival
(PFS), and Cox regression analysis was performed to identify the association
between progression-related factors and PFS.
Results:
Out of 90, true positive TCT was detected in 56 (62.2%) patients, true
negative in 19 (21.1%), false positive in 4 (4.4%), false negative in 11 (12.2%),
while 18F-FDG PET/CT was true positive in 69 (76.7%) patients, true negative in
10 (11.1%), false positive in 5 (5.5%), false negative in 6 (6.7%). Mean 18F-FDG
PET/CT SUVmax was 6.8 ±6.2. Diagnostic sensitivity of TCT was 83.6%, specificity 82.6%, accuracy 83.3% vs. 18F-FDG PET/CT sensitivity was 92.0%, specificity
66.7%, accuracy 87.8%. A significant correlation between Ki67 and SUVmax was
found in positive 18F-FDG PET/CT findings, unlike the correlation between Ki67
and Krenning score. Median PFS was 25 months (95% CI: 18.2–31.8), in 18F-FDG
PET/CT positive patients 23 months (95% CI: 16.3–29.7) and 18F-FDG PET/CT negative 26 months (p = 0.279). Progression-free survival predictors were SUVmax
and Krenning score.
Conclusions:
In our study, TCT and 18F-FDG PET/CT have high diagnostic accuracy in detection of NET. Higher Krenning score on TCT and SUVmax in positive 18F-FDG PET/CT findings are predictors of disease progression. 99mTc-Tektrotyd scintigraphy and 18F-FDG PET/CT can be useful complementary tools
in management of patients with NETs and in predicting patients’ outcome.