SOMATOSTATIN RECEPTOR SCINTIGRAPHY IN THE STAGING OF LYMPHOMAS

In this prospective study we evaluated the somatostatin receptor scint igraphy in the initial staging of 19 patients suffering from Hodgkin's CHD) and non-Hodgkin's lymphomas (NHL) and in the restaging of 16 pat ients. Scintigraphy was compared to the results of the methods applied for adequate staging of lymphoma patients in the large multicentre tr ials. Planar imaging and SPECT was performed after intravenous injecti on of 110 or 220 MBq of In-111-pentetreotide. The patient-based analys is yielded an overall sensitivity of 88%, contrasting lesion-based sen sitivities of 57%, 35%, and 43% in HD, low-grade NHL and high-grade NH L, respectively. The best results were obtained in the head-and-neck r egion and the worst in the abdomen (sensitivities of 61% and 24%, resp ectively). Bone marrow infiltration was visible in 1/12 cases only. Th ere was no significant difference between the outcomes of patients in the initial staging and restaging and no influence of the amount of in jected radiopharmaceutical on the results. In terms of the Ann-Arbor c lassification, 10/35 patients were concordant whereas 22 were understa ged and 3 overstaged scintigraphically. In conclusion, somatostatin re ceptor scintigraphy is not useful in the initial staging or restaging of malignant lymphomas, especially NHL, due to low lesion detection ra tes most probably because of low receptor densities. In addition, intr aindividual heterogeneity of somatostatin receptor expression has to b e considered.