SPECT/CT with radiolabeled somatostatin analogues in the evaluation of systemic granulomatous infections

Objective: To evaluate SPECT/CT with radiolabeled somatostatin analogues (RSAs) in systemic granulomatous infections in comparison with gallium-67 (67Ga) citrate scintigraphy. Materials and Methods: We studied 28 patients with active systemic granulomatous infections, including tuberculosis, paracoccidioidomycosis, pneumocystosis, cryptococcosis, aspergillosis, leishmaniasis, infectious vasculitis, and an unspecified opportunistic infection. Of the 28 patients, 23 had started specific treatment before the study outset. All patients underwent whole-body SPECT/CT imaging: 7 after injection of 99mTc-EDDA-HYNIC-TOC, and 21 after injection of 111In-DTPA-octreotide. All patients also underwent 67Ga citrate imaging, except for one patient who died before the 67Ga was available. Resultados: Vinte e sete sitios de atividade foram detectados com 67Ga em 20 de 27 pacientes, tambem vistos nos estudos com RSA. Ambos foram negativos nos outros 7 pacientes. A captacao de RSA foi visualmente menor que a de 67Ga em 11 de 20 pacientes positivos e similar nos outros 9. Um paciente que nao pode fazer cintilografia com 67Ga, fez biopsia guiada por 99mTc-EDDAHYNIC-TOC SPECT/CT em uma cavidade pulmonar com captacao desse tracador, que foi positiva para aspergilose. Conclusion: SPECT/CT with 99mTc-EDDA-HYNIC-TOC or 111In-DTPA-octreotide seems to be a good alternative to 67Ga citrate imaging for the evaluation of patients with systemic granulomatous disease.