octreotide scans

David,

all I know is from another specialist; that for certain carcinoids it shows nothing they haven't seen on others.

Maureen

Maureen

I think my dad is getting his injection done at the hospital Dr Etoch told him he would get an apt for 23 Dec to come up to get the Lanreotide injection and then every 28 days after that.

Hope the Y-90 treatment works out for you. Do you know how many cycles you will need and how long you need to stay at hospital for?

Does anyone know is there a difference between Lanreotide and Sandosatin or are they the same thing?

Jen
N Ireland

Jen,

Lan and san are roughly the same it depends which your body tolerates.

I'm on between 2-4 and you're in for 3-4 days. I'm hoping at the moment the NHS covers airfares and taxis. If your dad needs the Y-90 let me know and I'll give you the telephone number of a lovely taxi driver; he charged half of the price of the airport taxi which was total extortian!

M

Hi David

You asked for a clue as to when Gallium 68 scans might be useful. This is an extract from a 2007 paper by Irene Virgolini et al.-

68Ga-DOTA-Tyr3-Octreotide PET in Neuroendocrine Tumors: Comparison with Somatostatin Receptor Scintigraphy and CT

Michael Gabriel1, Clemens Decristoforo1, Dorota Kendler1, Georg Dobrozemsky1, Dirk Heute1, Christian Uprimny1,
Peter Kovacs2, Elisabeth Von Guggenberg1, Reto Bale2, and Irene J. Virgolini1
1Department of Nuclear Medicine, Innsbruck Medical University, Innsbruck, Austria; and 2Division of Diagnostic Radiology I,
Department of Diagnostic Radiology, Innsbruck Medical University, Innsbruck, Austria

The aim of this study was to evaluate the diagnostic value of a new somatostatin analog, 68Ga-labeled 1,4,7,10-tetraazacyclododecane-N,N9,N$,N$9-tetraacetic acid-D-Phe1-Tyr3-octreotide (68Ga-DOTA-TOC), for PET in patients with known or suspected neuroendocrine tumors. PET was compared with conventional scintigraphy and dedicated CT. Methods: Eighty-four patients (48 men, 36 women; age range, 28–79 y; mean age 6 SD, 58.2 6 12.2 y) were prospectively studied. For analysis, patients were divided into 3 groups: detection of unknown primary tumor in the presence of clinical or biochemical suspicion of euroendocrine malignancy (n 5 13 patients), initial tumor staging (n 5 36 patients), and follow-up after therapy (n 5 35 patients). Each patient received 100–150 MBq 68Ga-DOTA-TOC. Imaging results of PET were compared with 99mTc-labeled hydrazinonicotinyl-
Tyr3-octreotide (99mTc-HYNIC-TOC) and 111In-DOTA-TOC. CT was also performed on every patient using a multidetector scanner. Each imaging modality was interpreted separately by observers who were unaware of imaging findings before comparison
with PET. The gold standard for defining true-positive (TP), true-negative (TN), false-positive (FP), and false-negative (FN) results was based on all available histologic, imaging, and follow-up findings. Results: PET was TP in 69 patients, TN in 12 patients, FP in 1 patient, and FN in 2 patients, indicating a sensitivity of 97%, a specificity of 92%, and an accuracy of 96%. The FP finding was caused by enhanced tracer accumulation in the
pancreatic head, and the FN results were obtained in patients with a tumor of the gastrointestinal tract displaying liver metastases. 68Ga-DOTA-TOC showed higher diagnostic efficacy compared with SPECT (TP in 37 patients, TN in 12 patients, FP in 1 patient, and FN in 34 patients) and diagnostic CT (TP in 41 patients, TN in 12 patients, FP in 5 patients, and FN in 26 patients). This difference was of statistical significance (P , 0.001). However,
the combined use of PET and CT showed the highest overall accuracy.

Conclusion: 68Ga-DOTA-TOC PET shows a significantly higher detection rate compared with conventional somatostatin receptor scintigraphy and diagnostic CT with clinical impact in a considerable number of patients.

I've read several similar papers by different authors. They all reach a similar conclusion. It couldn't be that those who proclaim Gallium 68 scans are no better than octreoscans (a) don't read such stuff or (b) are protecting their budgets ... or maybe I'm missing something?

Hi Tim

I heard that the 68Ga scan was cheaper than an octreoscan, so I'm not sure its the money as such. John Buscombe of the Royal Free talked about the complications of getting the 68Ga-DOTATOC - they get theirs from somewhere in Poland I think he said. So the impression I got is that its a question of staff training and setting up supply lines instead of the amount of money involved. Presumably the rarity of noids doesn't help when hospitals departments are deciding what training is needed and what new equipment/supply lines to get in? [I'm imagining departmental meetings where all the cancer specialists are present to make their cases for new kit; and the common cancers get the lions share of resources.]

The other point (so I've been told) is that higher accuracy detection doesn't make much difference when it comes to planning treatments - the surgeons still have to go by their CT & MRI scans to plan the operation, and then use their hands & eyeballs; embolizations have to be guided by ultrasound to get the tube to the right blood vessels; RFA has to be guided by CT?; and biological treatments (octreotide, sirspheres etc) don't need scans as such. So if you've already been diagnosed and are undergoing treatment, the tools and scans and stuff needed are completely different anyway.

I'm not entirely convinced by what I've said above, I'm just reporting what I've been told. I do think a newly diagnosed noid would benefit from the most accurate scans possible; and if you've got reason to think it might have spread you'd want the most accurate scan possible - even if it didn't make any difference to what can be done by way of treatment.

Bye for now

Davida stated: "I've asked three specialists so far about the Ga-PET scan - Val, Dr Ramage & Dr Buscombe. They all say the Ga-PET scan wouldn't be particularly useful for me, but I'm still not clear when it would be useful. Dr Baum's talk on youtube does seem a bit like a marketing video [I love the photos of the boy at different stages of healing], so maybe the benefits are a bit overstated?

Does anyone know a bit more about it & when it would be useful?"


I used the Pet ga 68 and it was hand down better than anything else....the best thing you can do it you feel things are being oversold is bet into PUB MED or JOURNAL OF NUCLEAR MED and search for study data and results from MD....everything I have, INCLUDING MY EXPERIENCE, aligins with PET 68 is the GODL STANDARD for IMAGING OF NET TUMORS....one area is CUP...
Here is a write up with pleny of links to to hopefully satisfy a very good "show me" attitude which is ithis business if needed. BTW, they found bone lesions with the Pet 68 that was not seen at the Mother of all in USA- MDACC!!! The pics are on the blog also.

Hopefully this will help...DATA IS KEY:
[url=http://www.renalcarcinoid.com/2010/06/unknown-primary-neuroendocrine-tumor.html]

Hello Everyone.

Can anyone tell me what an Octreotide Scan does and how long is this scan and what if anything do I need to prepare - I have recently been advised that I need to have this scan.
I have been diagnosed wth having carciniod tumours in my Liver and will be going for treatment to the QE in Birmingham from this week.

Thanks
Paresh.

Hi Paresh

You go to the hospital and have an injection, go back 3 - 4 hours later and have a scan, which as far as I can remember takes about 1/2 - 45 mins. Then you go back the next day for another scan.

You dont need to prepare, only for the backwarding and forwarding to hospital. It doesn't hurt and the scan isn't scary, so hopefully you should be fine.

Sally

Hi Paresh,
The Octreoscan I had involved reporting on the afternoon of the first day to be given the radio labelled dose of an octreotide type substance, in form of injection. I was then free to go home, with restrictions as was giving of gamma rays. I returned the following 2 mornings for approx 4-5 hours of scanning. The gallium pet scan I had was a single visit of injection and 30 mins to an hour of scanning.

Hello Everyone,
I have now had the Ocreotide Scan and my results were clear everywhere else in my body appart from the tumours I have in the Liver. I had two tumours ablated on the right side of my liver (Radio frequency Ablasion - RFA) on Wednesday 25th August and now currently recovering. I have to go into Hospital again on the 8th September to under-go Liver Resection of part of the Left lobe - where I have the other 4cm tumour. Not sure about the recovery or how things will pan out for me afterwards, but thinking positive about it as I really have no choice in this matter. I hope everyone is well and thank you for your advice on the Octreotide Scan at least I was prepared with knowledge of what to expect. Thanks. Takecare for now, Paresh.