Diagnosed with a non hormone-producing, well-differentiated neuroendocrine tumor of the small intestine. A wide resection of the small intestine was practiced. Intraoperative examination of the gut did not disclose any other tumors in the intestinal mucosa. The patient recovered well and remained asymptomatic.
?One year after the surgery his cancer surgeon ordered an abdomial CT scan that was inhterpreted as unremarkable.
Three months later he was also examined by this cancer endocrinologists whom in turn also decide to order a somatosin receptor scintigraphy.
Teaching points:
SPECT should be a customary practice in cancer centers, either when using cancer tracer (e.g., In-111 or Tc-99m octreotide, I-131 sodium iodide, I-131 MIBG, Ga-67 citrate, Tc-99m(V) DMSA, Tc-99m MIBI) or not (e.g., Tc-99m MDP).
In recognition of the incremental value of image fusion, Nuclear Medicne technologists should always consider the potential medical necessity to retrospectively fuse non-concurrently obtained SPECT and CT or MR images.
Nuclear Medicine technologists should always follow a rigorous protocol to facilitate future image coregistration, including careful and reproducible patien positioning and using (radio-opaque and radioactive) external markers in a routinely fashion for every SPECT acquisition.
