Tc-99m-labeled somatostatin receptor-binding peptide imaging for a pulmonary nodule

A 76-year-old man with chronic obstructive pulmonary disease and a smoking history had a 2-cm solitary pulmonary nodule that was likely to be malignan t. He underwent Tc-99m-labeled somatostatin receptor-binding peptide SPECT. A computed tomographic-guided transthoracic needle biopsy performed before the SPECT was nondiagnostic. SPECT showed increased uptake of the tracer b y the nodule, which was subsequently found to be adenocarcinoma by surgical resection. Differentiation of malignant from benign nodules by Tc-99m-labe led somatostatin imaging may be a reasonable approach in patients at high r isk for cancer and concurrently at increased risk for complications from in vasive diagnostic procedures or surgical resection.