[Fusion of pulmonary scintigraphy with Tc99m-depreotide imaging with CT scan in recognizing solitary pulmonary nodule]. / Scyntygrafia pluc z 99mTc-depreotydem i nakladanie obrazów tomografii komputerowej w rozpoznawaniu pojedynczego guza pluca.

UNLABELLED: At present also radionuclide methods are used to diagnose pulmonary malignancies. One of them is solitary pulmonary nodule (SPN) scintigraphy using 99mTc-depreotide. 99mTc-depreotide is a somatostatin analogue with affinity to 3 out of 5 subtypes of somatostatin receptors. AIM OF THE STUDY: was to confirmed the usefulness of 99mTc-depreotide in detecting malignancy in SPN; finding lymph nodes metastases; and overlapping scintigraphic scans and CT in precise localizsation of malignancy and its lymph nodes metastases. MATERIAL AND METHODS: The group studied comprised 50 patients with radiologically diagnosed SPN. Forty patients had a high resolution CT scan done with a GE Light Speed equipment-device. The acquired CT scans were sent via LAN (Local Area Network) to an ARPACS server in the Department of Nuclear Medicine, and thence to a Hermes Nuclear Diagnostics workstation. CT examinations were followed by scintigraphy with 99mTc-depreotide. RESULTS: In 32 patients 99mTc-depreotide was found to have accumulated excessively in SPN: in 23 cases malignancy was found, in the 9 remaining cases they were other abnormalities. In the 23 lung cancer patients, 99mTc-depreotide was found in 24 foci, including 18 in the mediastinum and axillary region. CT revealed affected lymph nodes only in 7 cases. The calculated sensitivity, specificity and accuracy in SPN were 89%, 60%, 82%, respectively. The tumour/background index in malignancies confirmed histologically was 2.58 +/- 0.89. Where lymph nodes metastases were suspected in the diagnosed malignancies, the lymph node/background index was 2.60 +/- 0.85. In 25 cases lesion localization was more accurate when scans were overlapped. CONCLUSIONS: 99mTc-depreotide based examination is a sensitive method in the evaluation of SPN malignancy. Overlapping SPECT and CT scans in diagnosing SPN enables both pathological and physiological changes to be localized precisely. This method seems particularly valuable in imaging lymph nodes where metastases are suspected, especially when CT scans revealed no abnormalities.

[Technetium99 labelled synthetic somatostatin analogue (depreotide) in the diagnosis of peripheral solitary pulmonary nodules]. / Syntetyczny analog somatostatyny (depreotide) znakowany technetem99 w diagnostyce obwodowych zmian plucnych.

UNLABELLED: Lung carcinoma is one of the most common neoplasms, both in men and women. Many methods are employed within diagnostics approaches in oncology, among them are radiological, endoscopic, cytological and isotopic ones. Synthetic proteins labelled with gallium (Ga67), indium (In111) or technetium (Tc99) binding with receptors localised on cells surface enable scintigraphic determination of intensive uptake sites. The aim of the study was to asses clinical usefulness of technetium99 labelled synthetic somatostatin analogue (depreotide) in the diagnosis of solitary pulmonary nodules. Thirty one patients (19 men and 12 women) with isolated peripheral pulmonary lesions in chest X-ray examination were included into the study. All patients received intravenous infusion of synthetic protein compound, trifluorodepreotide acetate labelled with technetium99, with radio activity of 555-740 MBq (mega Becquerel) [Neospect--Nycomed Amersham, UK]. Radiopharmaceutical uptake was determined by two-head gamma camera according SPECT method (single photon emission computed tomography) after 3-4 hours after an injection. Intensive radiopharmaceutical uptake by abnormal lesions was found in 22 patients (71%), however in 9 (29%) it was not found in the sites of radiological changes. Among 22 patients with intensive uptake, in 17 (77%) patients a diagnosis of carcinoma was confirmed and in 5 patients benign lesions were diagnosed. In the group of 5 patients without marker uptake single case of carcinoma was found and in 4 benign lesions. Four patients refused further invasive diagnostic procedures. The sensitivity of this method was 94% with a specificity of 44%. No serious adverse clinical reactions associated with 99Tc depreotide were observed. CONCLUSIONS: 1. Technetium99 labelled synthetic somatostatin analogue [(depreotide) (NeoSpect)] is safe in pulmonological and oncological clinical diagnostics. 2. The use of this compound is a valuable scintigraphic, supplementary method to qualify patients for further invasive diagnosis of peripheral pulmonary solitary nodules.

[The advantages of depreotide in the diagnosis of spherical solitary pulmonary nodules (SPN): preliminary study]. / Przydatnosc depreotydu w diagnostyce obwodowych zmian plucnych--badanie wstepne.

The affinity of various malignant neoplasms including small cell and non-small cell lung cancer for peptide analogue of somatostatin has been documented. Depreotide is such an analogue and can be combined with technetium--99m (99mTc depreotide) for optical imaging properties. Using this radiopharmaceutical product, solitary pulmonary nodules (SPN) were previously successful evaluated. In this article the preliminary study of the depreotide (NeoSpect--Amersham, Wielka Brytania) in clinical practice has been shown.