99mTc-HYNIC-TOC increased uptake can mimic malignancy in the pancreas uncinate process at somatostatin receptor SPECT/CT

Radiol Med. 2016 Mar;121(3):225-8. doi: 10.1007/s11547-015-0593-2. Epub 2015 Nov 12.

Abstract

Objective: The aim of this study was to assess the occurrence and frequency of increased physiologic uptake of 99mTc-HYNIC-TOC by the uncinate process of the pancreas in SPECT/CT images.

Methods: Forty-six scans of 41 patients were evaluated retrospectively. The uptake of 99mTc-HYNIC-TOC was considered to be physiologic in patients with normal findings at dedicated abdominal CT or MR and lack of neoplastic lesions in clinical follow-ups. The intensity of uncinate process uptake was compared to the uptake of the normal liver.

Results: Focal uptake was attributed to the presence of pancreatic NET in 5 patients. Among the 36 patients without any evidence of malignancy in CT, MR and follow-up, 7 (19.4 %) showed increased uptake in the uncinate process. The intensity of uptake was lesser in 3 (8.3 %), similar in 3 and greater than the normal liver in 1 (2.8 %) case.

Conclusion: Increased 99mTc-HYNIC-TOC uptake occurred in 19.4 % of those subjects without any evidence of neuroendocrine tumor in the uncinate process.

Keywords: 99mTc-HYNIC-Tyr3-octreotide; Neuroendocrine tumors; SPECT-CT; Somatostatin receptor imaging.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Liver / metabolism
  • Male
  • Middle Aged
  • Multimodal Imaging*
  • Neuroendocrine Tumors / diagnosis
  • Octreotide / analogs & derivatives*
  • Octreotide / pharmacokinetics
  • Organotechnetium Compounds / pharmacokinetics*
  • Pancreas / metabolism*
  • Radiopharmaceuticals / pharmacokinetics*
  • Receptors, Somatostatin
  • Retrospective Studies
  • Tomography, Emission-Computed, Single-Photon*
  • Tomography, X-Ray Computed*

Substances

  • Organotechnetium Compounds
  • Radiopharmaceuticals
  • Receptors, Somatostatin
  • technetium Tc 99m hydrazinonicotinyl-Tyr(3)-octreotide
  • Octreotide