Somatostatin receptor scintigraphy screening in advanced hepatocarcinoma: A multicenter French study

Abstract

Background: Somatostatin receptor scintigraphy (SRS) has been reported for receptor (SSTR) screening in advanced hepatocarcinoma (aHC) prior to somatostatin analogue treatment. Aims: To evaluate SSTR screening with SRS in aHC patients. Methods: SRS was performed prior treatment, with images at 4, 24, 48 hours. For 7 tumors, SSTR2 subtype was detected immunohistochemically. Results: 70 aHC patients (63 men) aged 65±11 years were included, with alcohol, viral or other causes cirrhosis in 35(50%), 23(33%), 12(17%) cases respectively. CLIP score was 2.7±1.7, with more than 3 nodules in 37(53%) cases. Largest nodule measured 7.6±4.5 cm. Median alpha-fetoprotein was 574 UI/mL. SRS was positive in 25/70 (35.7%) livers and 7/17 (41.2%) metastatic sites. Positive SRS patients differed from others for tumor size (9.2±4 vs. 6.7±4.6 cm, p=0.03), prothrombin time (PT) (75.2±15.2 vs. 61.9±19 %, p=0.005), albumin (34.1±5.9 vs. 30.5±7.2 g/L, p=0.04) and Child-Pugh (6.7±1.8 vs. 7.7±2.3, p=0.04). After multivariate analysis, only PT was associated with positive SRS (p=0.028). Immunohistochemistry was positive for SSTR2s in 6/7 tumors (SRS uptake in 5/6 cases). Conclusions: In advanced hepatocarcinoma, we report SRS uptake in 35.7% of livers and 41.2% of metastatic sites. SRS value in sreening patients for somatostatin analogue treatment remains to be assessed.