IN-111 OCTREOTIDE SCINTIGRAPHY IN THE EVALUATION OF HEAD AND NECK LESIONS

PURPOSE: To evaluate indium 111 octreotide scintigraphy for the detect ion of suspected neuroendocrine lesions of the head and neck, METHODS: After receiving 6 mCi of (111)ln octreotide, 22 patients with suspect ed lesions of the head and neck were examined with both planar and sin gle-photon emission CT (SPECT). Static images, obtained at 4 hours, in cluded the head/neck, chest, abdomen, and pelvis. Additional SPECT ima ges were obtained at 4 or 24 hours, Studies were compared with availab le conventional radiologic examinations (12 CT, 11 MR, and three angio graphic studies) as well as with clinical and pathologic findings. RES ULTS: Eighteen of the 22 patients had abnormal findings at scintigraph y, Eleven paragangliomas were seen in 10 patients, metastatic medullar y thyroid carcinoma in three patients, thyroid adenoma in two patients , and Merkel cell tumor, carcinoid, and plasmacytoma in one patient ea ch, Surgical confirmation was available in 13 patients, The smallest l esion detected was 1.5 cm. There was one false-positive and one false- negative examination, CONCLUSION: In-111 octreotide scintigraphy is a useful imaging tool for the detection of primary and metastatic neuroe ndocrine tumors of the head and neck that are larger than 1.5 cm, This technique enables distinction of glomus tumors from other masses (suc h as neuromas) and can be used in the postoperative setting to disting uish scar from recurrent paraganglioma, Since it is an examination of the entire body, it has great utility for detecting multicentric parag anglioma and for screening patients with familial paraganglioma.