111In-pentetreotide scintigraphy in medulloblastoma: a comparison with magnetic resonance imaging

Acta Oncol. 2007;46(1):111-7. doi: 10.1080/02841860600833152.

Abstract

Medulloblastoma (MB) is a primitive neuroectodermal tumour constituting a grade IV brain malignancy. Early and correct detection of recurrence or metastasis is desirable for follow-up of patients in this entity. Frequent expression of somatostatin receptors by MB lesions facilitates functional tumour imaging by somatostatin receptor scintigraphy (SRS). To investigate the value of SRS in the follow-up of MB, the results of ten consecutive patients (seven children and three adults) undergoing additional imaging with 111In-pentetreotide were reviewed. Four, 24 and 48 h p.i. planar and whole body images as well as a SPECT study at 4 h p.i. were acquired after intravenous injection of 109 +/- 35 MBq 111In-pentetreotide (Octreoscan). SRS yielded 11 positive and ten negative imaging results, compared to 17 positive and four negative in magnetic resonance imaging (MRI). The lesion-by-lesion analysis with a total of 44 lesions revealed a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 42%, 83%, 94%, 18% for SRS and 89.5%, 50%, 92%, 43% for MRI. Based on a per-patient analysis, considering the patient as to be either tumour-free or tumour-positive by one imaging modality, the following values for sensitivity, specificity, PPV and NPV were obtained: 61%, 100%, 100%, 30% for SRS and 94%, 67%, 94%, 67% for MRI. MRI remains the first step imaging technique in medulloblastoma patients before and after surgery and during the follow-up providing the highest sensitivity. However, to improve specificity and contribute to correct diagnosis in MB 111In-pentetreotide scintigraphy should be considered as a confirmatory second step imaging tool, especially in case of equivocal MRI results. Moreover, a positive SRS scan might serve as a reference before and after somatostatin receptor targeted radiotherapy.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cerebellar Neoplasms / diagnosis*
  • Cerebellar Neoplasms / diagnostic imaging
  • Child
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Medulloblastoma / diagnosis*
  • Medulloblastoma / diagnostic imaging
  • Predictive Value of Tests
  • Receptors, Somatostatin
  • Sensitivity and Specificity
  • Somatostatin / analogs & derivatives*
  • Tomography, Emission-Computed, Single-Photon
  • Whole Body Imaging

Substances

  • Receptors, Somatostatin
  • Somatostatin
  • pentetreotide