SRS was performed with 111In-pentetreotide imaging (Octre-oscan®: 111Indium-labelled pentetreotide; Mallinckrodt Medical, St Louis, MO, USA). 111In-pentetreotide has a high affinity to bind to SSTR2 and also binds to SSTR3 and SSTR5.13 (link),21 (link) Following intravenous injection of 111In-pente-treotide, whole-body planar images were obtained at 4 h and 24 h postinjection. If interpretation of the planar images was equivocal, single-photon emission computed tomography with computed tomography (SPECT/CT) was performed. All images were independently re-evaluated by two dual board-certified (radiology and nuclear medicine) radiologists at our institution. They were blinded to the results of the initial scan evaluation and to the clinical outcomes. Disagreement on a particular image evaluation was resolved through discussion between the two radiologists. A semiquantitative scale was developed to analyse 111In-pentetreotide positivity based on the previously described Krenning score for NETs.22 (link)111In-pentetreotide uptake on SRS indicates SSTR expression. The degree of uptake can further be described as low when uptake is lower than in the liver but greater than in the blood pool, medium when uptake equals that of the liver, and high when uptake is greater than in the liver. 111In-pentetreotide uptake equal to or less than in the blood pool is considered negative.
Octreoscan
Manufactured by Mallinckrodt
Sourced in United States, Netherlands
Octreoscan is a diagnostic imaging agent used in nuclear medicine procedures. It contains the synthetic peptide octreotide, which binds to somatostatin receptors expressed by certain types of neuroendocrine tumors. Octreoscan is used to detect the presence and location of these tumors in the body.
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Lab products found in correlation
5 protocols using octreoscan
1
Somatostatin Receptor Imaging with 111In-pentetreotide
2
Lu-177 DOTATATE Therapy for Neuroendocrine Tumors
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This study included 41 patients with advanced neuroendocrine tumours. The study was approved by the Regional Ethics Review Board in Gothenburg, Sweden, and performed in accordance with the principles of the Declaration of Helsinki and national regulations. The need for written informed consent was waived. Patients included in the study had tumours judged to overexpress somatostatin receptors (i.e., uptake exceeding physiological liver uptake) by somatostatin receptor scintigraphy (111In-DTPA-octreotide, Octreoscan®; Mallinckrodt). All patients had clinically, biochemically, or radiologically confirmed progressive disease and a renal 51Cr-EDTA clearance >40 mL/min/1.73 m2. Each fraction was administered as a 30-min infusion of 7.2 ± 1.3 GBq (3.5–8.3 GBq) of 177Lu-DOTATATE coinfused with kidney-protecting amino acids (2.5 % lysine and 2.5 % arginine in 1 L of 0.9 % NaCl, infusion rate 250 mL/h) to a total amount of 24 ± 7.1 GBq (8.2–40 GBq) on two to five occasions, 6–8 weeks apart.
3
Neuroendocrine Tumor Patients Treated with 177Lu-octreotate
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The study included 320 Dutch patients who were treated from January 2000 to December 2007. Inclusion criteria were: patients with neuroendocrine tumour and baseline tumour uptake on [111In-DTPA0] octreotide scintigraphy (OctreoScan®; Mallinckrodt, Petten, The Netherlands) with accumulation in the tumour at least as high as in normal liver tissue; no prior treatment with PRRT; baseline serum haemoglobin (Hb) ≥6 mmol/l; white blood cell (WBC) count ≥2 × 109/l; platelet (PLT) count ≥ 75 × 109/l; serum creatinine ≤150 µmol/l or creatinine clearance ≥40 ml/min and Karnofsky performance status ≥50. Only Dutch patients were selected, because loss to follow-up is limited in these patients.
This study was part of the ongoing prospective study in patients with neuroendocrine tumours treated with 177Lu-octreotate at the Department of Nuclear Medicine, Erasmus University Medical Center Rotterdam. The hospital’s medical ethics committee approved the study. All patients gave written informed consent for participation in the study.
This study was part of the ongoing prospective study in patients with neuroendocrine tumours treated with 177Lu-octreotate at the Department of Nuclear Medicine, Erasmus University Medical Center Rotterdam. The hospital’s medical ethics committee approved the study. All patients gave written informed consent for participation in the study.
4
Long-term Evaluation of 177Lu-Octreotate Treatment
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A total of 615 patients, who were treated from January 2000 to December 2007 were studied. Inclusion criteria for the study were: patients with somatostatin positive tumours and baseline tumour uptake on [111In-DTPA0]Octreotide scintigraphy (Octreoscan®; Mallinckrodt, Petten, The Netherlands) with accumulation in the tumour at least as high as in normal liver tissue; no prior treatment with PRRT; baseline serum haemoglobin (Hb) ≥6 mmol/l; white blood cells ≥2 109/l; platelets ≥75 109/l; Karnofsky performance status ≥50; serum creatinine ≤150 μmol/l; and 24-h CLR ≥40 ml/min. Of the 615 patients, 323 Dutch patients were selected for this long-term evaluation, because loss to follow-up is limited in these patients.
This study was part of an ongoing prospective study in patients with neuroendocrine tumours treated with 177Lu-Octreotate at the Department of Nuclear Medicine, Erasmus University Medical Center Rotterdam. The hospital’s medical ethics committee approved the study. All patients gave written informed consent for participation in the study.
This study was part of an ongoing prospective study in patients with neuroendocrine tumours treated with 177Lu-Octreotate at the Department of Nuclear Medicine, Erasmus University Medical Center Rotterdam. The hospital’s medical ethics committee approved the study. All patients gave written informed consent for participation in the study.
5
Somatostatin Receptor Scintigraphy Protocol
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Somatostatin receptor scintigraphy in all the patients was performed following an intravenous injection of about 170.0 MBq of 111-In-DTPA-Phe-octreotide (OctreoScan®, Mallinckrodt Medical, Petten, Netherlands) using a large field of view double-headed gamma camera (SymbiaT6®, Siemens Medical Solutions, Erlangen, Germany) equipped with a medium energy collimator. An adequate colonic preparation was made to remove the background gastrointestinal radioactivity. For the purpose, 30.0 g of lactulose was administered in the evening after injection and then next day in the morning before acquiring the 24-h delayed image. Patients’ preparation also included residue-free diet 3 days prior to performing SRS. Three static anterior and posterior spot views covering the head and neck, thorax, abdomen, and pelvis were acquired at 4 and 24 h (256 × 256 matrix, 15 min per view). At 24 h, SPECT/CT acquisition was also made of the area corresponding to the abnormal uptake on the planar images.
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