Study On The Role Of Somatostatin Receptor Imaging In The Diagnosis And Treatment Of Neuroendocrine Tumors

Objective:This study intends to develop somatostatin receptor PET/CT imaging for suspected gastrointestinal neuroendocrine tumors detected by clinical endoscopy,ultrasound,CT and other tests.Its diagnostic tips will provide scientific guidance for the diagnosis,differential diagnosis and optimal treatment of neuroendocrine tumors,which has important clinical significance.Methods:A retrospective analysis was made of 48 outpatients/inpatients with suspected and confirmed gastrointestinal neuroendocrine tumors found by bedside ultrasound,CT,endoscopy and other means in Shanxi Provincial Cancer Hospital from July 2020to June 2022.The patients underwent ¹⁸F-OCT PET/CT imaging and conventional PET/CT examination respectively,and the clinical baseline data and pathological data of the patients were recorded;The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of ¹⁸F-OCT PET/CT imaging and conventional PET/CT imaging in the diagnosis of gastrointestinal neuroendocrine tumors were collected.The SUVmax in ¹⁸F-OCT PET/CT imaging and conventional PET/CT in patients with different pathological grades were gathered.Estimate the diagnostic sensitivity of ¹⁸F-OCT PET/CT imaging and conventional PET/CT imaging in patients with gastrointestinal neuroendocrine tumors and metastases with different pathological grades.Results:（1）Among the 48 patients included,30 patients were eventually confirmed to be positive by puncture biopsy or surgical pathology,accounting for 62.50%,and 18patients were negative,accounting for 37.50%;The course of 30 positive patients was1 to 14 months,with an average of（4.37±1.19）months;18 cases（60.00%）of positive patients had a diameter of>2.0cm,12 cases（40.00%）of≤2.0cm;In terms of pathological staging of positive patients,there were 13 cases in G1 phase,accounting for 43.33%,13 cases in G2 phase,accounting for 43.33%,and 4 cases in G3 phase,accounting for 13.34%;In terms of the incidence site of positive patients,there were14 cases of upper digestive tract,accounting for 46.67%,including 1 case of gastric antrum,5 cases of gastric body,1 case of gastric fundus,1 case of esophagus,1 case of duodenal papilla,2 cases of duodenal bulb,4 cases of pancreas,16 cases of lower digestive tract,accounting for 53.33%,including 1 case of ileocecal part,1 case of sigmoid colon,1 case of terminal ileum,and 13 cases of rectum;In terms of focus metastasis,there were 8 cases with metastasis,accounting for 26.67%,and 22 cases without metastasis,accounting for 73.33%.（2）The diagnosis of gastrointestinal neuroendocrine tumors was found to be sensitive to 18F-OCT PET/CT imaging,with a sensitivity of 93.33%（28/30）,specificity of 94.44%（17/18）,a positive predictive value of 96.55%（29/30）,a negative predictive value of 89.47%（17/18）,and accuracy of 93.75%（45/48）.Routine PET/CT was found to have a sensitivity,specificity,positive predictive value,negative predictive value,and accuracy for the diagnosis of gastrointestinal neuroendocrine tumors,with results of 60.00%（18/30）,66.67%（12/18）,75.00%（18/24）,50.00%（12/24）and 62.50%（30/48）respectively.18F-OCT PET/CT imaging was found to possess a significantly higher sensitivity,specificity,positive predictive value,negative predictive value and accuracy in the diagnosis of gastrointestinal neuroendocrine tumors than conventional PET/CT imaging（P<0.05）.（3）The SUVmax of ¹⁸F-OCT PET/CT imaging in grade G1 and G2 patients was higher than that of conventional PET/CT imaging,the difference was statistically significant（P<0.05）;There was no significant difference in SUVmax between¹⁸F-OCT PET/CT imaging and conventional PET/CT imaging in G3 patients（P>0.05）.（4）The sensitivity of ¹⁸F-OCT PET/CT imaging to G1 and G2 patients was92.31%（12/13）and 92.31%（12/13）respectively,which was significantly higher than38.46%（5/13）and 69.23%（9/13）of conventional PET/CT imaging（P<0.05）;There was no significant difference in sensitivity between ¹⁸F-OCT PET/CT imaging and conventional PET/CT imaging in detecting G3 patients and patients with metastatic lesions（P>0.05）.Conclusion:Somatostatin receptor imaging has a high diagnostic efficiency for primary and metastatic lesions of gastrointestinal neuroendocrine tumors,and the lower the pathological grade of patients,the more obvious the advantages of somatostatin receptor imaging,which has important reference value for clinical treatment decisions of patients.