Combined use of111In-labeled pentetreotide and three-step immunoscintigraphy with antichromogranin a monoclonal antibody in the diagnosis of pituitary adenomas |
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Authors: | Magnani P Paganelli G Siccardi A G Songini C Colombo P Faglia G Fazio F |
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Institution: | (1) INB-CNR, DIBIT, IRCCS H S. Raffaele, Via Olgettina 60, I-20132 Milan, Italy;(2) IRCCS Ospedale Maggiore, University of Milan, Milan, Italy |
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Abstract: | For various pituitary adenomas, it has been demonstrated that somatostatin receptor can be present. Pilot studies have shown
that radio-indium labeled pentetreotide allows very good scintigraphic localization of somatostatin receptor-bearing cell
masses. Recently, the presence of CgA in pituitary adenomas has also been demonstrated. MAb A11, raised against CgA, has been
successfully used with a three-step ISG for the diagnosis of neuroendocrine tumors. Therefore the combined use of three-step
ISG with MAb A11 and radiolabeled somatostatin can be useful in the diagnosis of pituitary adenomas. Twelve patients, 5 secreting
(group A) and 7 nonsecreting (group B) pituitary adenomas, were enrolled in the study. All patients underwent three-step ISG,
and, 2 wk later, scintigraphy with111In-labeled pentetreotide (Octreoscan). Three-step ISG consisted of iv injection of 1 mg of biotinylated MAb A11 (first step),
followed by 10 mg of avidin (second step) and 99mTc]PnAO-biotin (third step). Tomographic imaging were acquired for three-step ISG and Octreoscan at 2 and 4 h after radiotracer
injection, respectively. The results are the following: 2 patients of group A (secreting tumors) had a positive three-step
ISG, whereas all the patients but one of the same group had a positive pentetreotide study; all the patients of group B (nonsecreting
tumors) had a positive three-step ISG and 4 had a positive pentetreotide scintigraphy. These data suggest the utility of the
combined use of these techniques for a better diagnosis of pituitary adenomas. |
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Keywords: | Immunoscintigraphy chromogranin A human antiavidin response human antimouse antibody |
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