99mTc-depreotide scintigraphy of bone lesions in patients with lung cancer

Abstract

Purpose: Scintigraphy with 99mTc-depreotide, a somatostatin analogue-technetium ligand, has been used for evaluation of various malignant neoplasms, including lung cancer. The diagnosis of bone metastases in patients with lung cancer is not always definitive with current imaging methods. Visualisation of somatostatin receptors (SSTRs) in bone lesions, when the primary tumour exhibits such receptors, could be helpful in characterising them as metastatic. The aim of this study was to assess the value of 99mTc-depreotide in differentiating between benign and malignant bone lesions in patients with lung cancer.

Methods: The study population comprised 20 patients (17 males and three females, mean age 63 years) with proven lung cancer in whom bone lesions had been detected by conventional imaging methods. All patients underwent 99mTc-hydroxydiethylene diphosphonate and 99mTc-depreotide scintigraphy within 2 weeks. Bone lesions were classified as benign or malignant on the basis of clinical, imaging and/or histological criteria.

Results: 99mTc-depreotide uptake in the primary tumour was seen in 19 of the 20 patients. Conventional imaging methods detected 55 bone lesions, 31 of which were classified as malignant. Twenty-eight (90%) of these lesions showed 99mTc-depreotide uptake, suggesting bone metastases, while three did not. Twenty-four bone lesions were classified as benign by conventional imaging methods, and none of them showed 99mTc-depreotide uptake. In addition, 99mTc-depreotide demonstrated extra-osseous lesions in six patients.

Conclusion: In patients with lung cancer and bone lesions, 99mTc-depreotide scintigraphy uptake in the bone lesions supports the diagnosis of malignancy, in particular if the primary lung tumour also exhibits SSTRs. Furthermore, whole-body 99mTc-depreotide scintigraphy may disclose extra-osseous disease.