SPECT/CT with a New Radiopharmaceutical "99mtc, Octreotide" in Diagnosis and Evaluation of the Effectiveness of Treatment of Neuroendocrine Tumor of the Lung (Clinical Case)

Purpose: to demonstrate the possibilities of using SPECT/CT with the new radiopharmaceutical “^99mTс, Octreotide” in the diagnosis, assessment of the extent of the process and monitoring of the effectiveness of treatment of neuroendocrine lung tumors.

Material and methods: the presented clinical case examines the medical history of a patient with verified neuroendocrine cancer of the right lung with extensive local spread and the presence of distant lymph node metastases (retroperitoneal lymph nodes) and hematogenous dissemination to bones (ribs and vertebrae). During the initial diagnosis and at the stages of chemotherapy treatment, along with traditional methods of instrumental and laboratory examination, the patient underwent “^99mTc, Octreotide” SPECT/CT. The results of the study were assessed visually and using the SUV (standardized accumulation level). When interpreting the results of “^99mTc, Octreotide” SPECT/CT with special attention was paid to the dynamics of the SUV indicator at control points for assessing the effectiveness of chemotherapy treatment.

Results: The results obtained demonstrated the possibility of effective use of “^99mTc, Octreotide” SPECT/CT at the stage of primary diagnosis of a neuroendocrine tumor. The data obtained not only confirmed the presence of a malignant tumor of a neuroendocrine nature in the patient, but also made it possible to correctly stage the tumor process, since additional pathological foci were identified in distant lymph nodes and bones. In addition, the use of “^99mTc, Octreotide” SPECT/CT during control examinations at the stages of chemotherapy treatment of a patient made it possible to supplement the significance of diagnostic information obtained using traditional research methods and to more reliably assess the effectiveness of the therapy. Already at the first control examination, pronounced positive dynamics were observed after 3 courses of chemotherapy in the form of a decrease in the number of foci of pathological accumulation of “^99mTc, Octreotide” and a decrease in the intensity of its inclusion in the remaining areas of the tumor lesion. Also, during further examinations at control points, the opposite – negative dynamics was noted in the form of the appearance of new foci of pathological accumulation of “^99mTc, Octreotide”.

Conclusion: The presented experience in the clinical use of “^99mTc, Octreotide” SPECT/CT demonstrated the effectiveness and ease of use of this method in patients with neuroendocrine tumors. In addition, the results obtained today make it possible to successfully use the new domestic radiopharmaceutical for the diagnosis of neuroendocrine tumors.