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J Nucl Med. 2008; 49 (Supplement 1):115P
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Oncology-Clinical Diagnosis: Solid Tumors

Neuroendocrine and Head & Neck Cancers

99mTc-Demogastrin 2 for CCK 2-receptor scintigraphy in medullary thyroid carcinoma

Alida Fröberg1, Berthold Nock2, Theodosia Maina2, Marion De Jong1, Wouter De Herder3, J. Hans De Wilt4, Aad Van der Lugt5, Erik De Blois1, Caroline Hijmans1 and Eric Krenning1

1 Nuclear Medicine, Erasmus MC Hospital, Rotterdam, Netherlands; 2 Molecular Radiopharmacy, I/R-RP, NCSR "Demokritos", Athens, Greece; 3 Internal Medicine; 4 Surgery; 5 Radiology, Erasmus MC, Rotterdam, Netherlands

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Objectives: As 99mTc-N4-Gly-(D)Glu-(Glu)5-Ala-Tyr-Gly-Trp-Met-Asp-Phe-NH2 (99mTc-Demogastrin 2) had shown promising results in preclinical studies, we investigated the diagnostic potential of this peptide in patients with evidence of recurrence or metastases of medullary thyroid cancer (=MTC) after thyroid surgery.

Methods: 23 patients (pts) (16 female; age 17- 76 y, median 43 y) were studied with 24 scans. 12 pts had elevated calcitonin levels but no known tumor localization. Scintigraphy was performed at 3-4 and/or 8 and/or 24 h post injection of ± 800 MBq 99mTc-Demogastrin 2 (± 10 µg peptide).

Results: Only mild and quickly disappearing side effects were noticed. 18 scans were judged as positive. Except for small liver metastases (3 mm; scan equivocal) all known metastases were visible; in 8 pts with known tumor localizations extra lesions were located. In 12 pts without known tumor lesions, 7 scans were judged positive in neck, mediastinum, hilum, bone, lung and/or liver. 3 lesions have not yet been confirmed by correlating imaging. In 2 pts with negative scans, neck lesions were subsequently discovered and resected, in-vitro autoradiography showed lack of clear CCK 2-receptor overexpression.

Conclusions: CCK 2-receptor imaging with 99mTc-Demogastrin 2 appears to be a very promising diagnostic tool in patients with MTC and can be helpful in localizing both local and distant metastases in patients with elevated calcitonin levels. Further studies have to define its value in patient management.





This Article
Services
Right arrow Email this article to a friend
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Right arrow Alert me to new issues of the journal
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Google Scholar
Right arrow Articles by Fröberg, A.
Right arrow Articles by Krenning, E.
PubMed
Right arrow Articles by Fröberg, A.
Right arrow Articles by Krenning, E.