Introduction: Currently, the diagnosis of salivary gland tumors using imaging techniques is unreliable. Methods: In this monocentric retrospective study, we examined patients who received a68Ga-DOTATOC PET/CT and subsequently underwent a salivary gland tumor resection between 1 January 2010 and 31 December 2021. PET/CT image assessment was compared with somatostatin receptor (SSTR) expression and histology. Results: Thirteen patients (five pleomorphic adenoma (PA) and eight other parotid lesions (OPL)) received a68Ga-DOTATOC PET/CT. Imaging displayed strong focal tracer uptake in all PA except for one with strong tumor to background discrimination. PA revealed higher SUVmax, SUVmean, liver and blood pool quotients than those of Warthin tumors (WT) and of OPL. In comparison to the contralateral parotid, SUVmax (p= 0.02), SUVmean (p= 0.02), liver quotient (p= 0.03) and blood pool quotient (p= 0.03) were all significantly higher. In contrast, WT and OPL showed in relation to the contralateral parotid no significant differences of SUVmax (WTp= 0.79; OPLp= 0.11), SUVmean (WTp= 1.0; OPLp= 0.08), liver quotient (WTp= 0.5; OPLp= 0.08) and blood pool quotient (WTp= 0.8; OPLp= 0.19). Two PA and one granuloma were not available for examination. In the immunohistochemal analysis, all PA demonstrated the highest intensity of SSTR2 expression (grade 3). Furthermore, PA had a high percentage of cells expressing SSTR2 (20%, 80% and 55%). Conclusions: A strong tracer uptake in PA was shown in68Ga-DOTATOC PET/CT. This may allow physicians to utilize radioligated somatostatin analogue PET CT/MR imaging to accurately diagnose PA. Additionally, it may be possible in the future to treat the PA with a noninvasive peptide receptor radionuclide therapy or with somatostatin analogues.
引言：目前，影像学技术对唾液腺肿瘤的诊断尚不可靠。方法：在这项单中心回顾性研究中，我们纳入了2010年1月1日至2021年12月31日期间接受68Ga-DOTATOC PET/CT检查并随后进行唾液腺肿瘤切除术的患者。将PET/CT图像评估结果与生长抑素受体表达及组织学检查结果进行对比。结果：13例患者（5例多形性腺瘤及8例其他腮腺病变）接受了68Ga-DOTATOC PET/CT检查。影像显示除1例具有显著肿瘤-背景对比差异外，所有多形性腺瘤均呈现明显的局灶性示踪剂摄取。与沃辛瘤及其他腮腺病变相比，多形性腺瘤的SUV最大值、SUV平均值、肝脏比值及血池比值均更高。与对侧腮腺相比，多形性腺瘤的SUV最大值、SUV平均值、肝脏比值及血池比值均显著升高。相比之下，沃辛瘤及其他腮腺病变与对侧腮腺相比，在SUV最大值、SUV平均值、肝脏比值及血池比值方面均无显著差异。2例多形性腺瘤及1例肉芽肿未能获得检测样本。免疫组化分析显示，所有多形性腺瘤均呈现最高强度的SSTR2表达。此外，多形性腺瘤中表达SSTR2的细胞比例较高。结论：68Ga-DOTATOC PET/CT显示多形性腺瘤具有显著的示踪剂摄取特征。这一发现可能使临床医生能够利用放射性标记生长抑素类似物PET CT/MR成像技术实现多形性腺瘤的精准诊断。未来或可进一步探索通过无创性肽受体放射性核素疗法或生长抑素类似物治疗多形性腺瘤的新途径。
Novel Detection of Pleomorphic Adenomas via Analysis of68Ga-DOTATOC PET/CT Imaging
肿瘤(癌症)患者之家