Somatostatin receptor scintigraphy in surveillance of pediatric brain malignancies

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Abstract
Background: Somatostatin receptor scintigraphy (SRS) has been successfully used in imaging PBTs and, as a functional imaging modality, may be better able to differentiate tumor from scar/necrosis. This retrospective study evaluates the role of SRS in post‐treatment surveillance of PBTs.Procedure: Twenty children (age range: 7 months to 24 years, mean: 9 years) with known brain malignancies underwent serial SRS and MRI. The sensitivity and specificity of SRS and MRI were compared for surveillance scanning using patient outcome as the reference standard. Somatostatin receptors (sstrs) expression was determined by immunohistochemistry (IHC) of available tumor specimens.Results: SRS was true positive (TP) in 15 of 16 patients with proven disease found post‐resection (n = 5) or during follow‐up (n = 11). In contrast, MRI was positive in 12 of these 16 patients and equivocal in another two patients where it could not distinguish between radiation necrosis and tumor recurrence. The two patients with false negative (FN) MRI and proven disease were positive by SRS. SRS was negative in all four patients with no evidence of disease by follow‐up (mean follow‐up = 58 months). The only patient with a FN SRS (TP by MRI) was one without IHC evidence of sstrs. SRS was TP in 7/7 tumors with IHC documented sstrs.Conclusions: SRS is a useful adjunct to MRI for post‐treatment surveillance of sstr‐positive PBTs, particularly when MRI is equivocal. Pediatr Blood Cancer 2008;50:561–566.