Contribution of (99m)Tc-depreotide (Neospect) scintigraphy in lung cancer staging

The aim of this study was to evaluate the usefulness of scintigraphy with (99m)Tc-depreotide in the staging of lung cancer, especially in cases where CT findings are doubtful.

53 patients with suspected lung cancer were investigated with whole body planar acquisition and single photon emission computed tomography (SPECT) of the thorax after i.v. injection of 740 MBq (99m)Tc-depreotide (Neospect). The results were compared with CT and correlated with histological findings.

In 50 of 53 patients the biopsy was positive for bronchogenic carcinoma (31 patients with non small cell lung cancer [NSCLC], 18 with small cell lung cancer (SCLC), and 1 patient with neuroendocrine cancer). In the remaining 3, biopsy revealed no bronchogenic carcinoma (3 patients with inflammation). In 2/31 patients with NSCLC and doubtful CT findings, uptake of (99m)Tc-depreotide was the only non invasive reliable staging method.

It seems that scintigraphy with (99m)Tc-depreotide in patients with SCLC does not change the tumor stage, whereas in NSCLC the contribution of Neospect in lung cancer staging may be a helpful tool, especially in cases where CT alone is unable to distinguish between IIIA and IIIB stages (operable from non operable status).