ADRENAL-GLANDS IMAGING WITH INDIUM-111-DTPA-D-PHE(1)-OCTREOTIDE FOLLOWING ACTH THERAPY

Somatostatin receptors have been identified in a variety of neuroendoc rine tumors and activated leukocytes. A high density of somatostatin r eceptors is also present in most intestinal intramural veins of patien ts with inflammatory bowel disease. We present a case of a 25-yr-old f emale with severe Crohn's disease unresponsive to medical therapy, inc luding adrenocorticotropic hormone (ACTH) administration. The patient underwent In-111-DTPA octreotide scintigraphy to evaluate the potentia l role of somatostatin receptor imaging in inflammatory bowel disease. Despite the lack of significant somatostatin receptors in the affecte d bowel, an unexpected prominent activity of In-111-DTPA octreotide wa s noted in the adrenal glands on the SPECT images, presumably resultin g from excessive stimulation by ACTH. The expression of somatostatin r eceptors in the stimulated adrenals may be used to image other adrenal pathologies and could potentially indicate response to therapy.