[99mTc]Tc-HYNIC-Octreotide scintigraphy in melanoma: A preliminary report

Document Type : Original Article

Authors

1 Oncosurgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

4 Kidney Transplantation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

5 Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction: This study aimed to evaluate the expression of SSTRs in metastatic melanoma lesions using [99mTc]Tc-HYNIC-Octreotide whole-body scintigraphy and SPECT/CT imaging, and to assess its potential role in identifying candidates for receptor-targeted therapies such as peptide receptor radionuclide therapy (PRRT) with [177Lu]Lu-DOTATATE.
Methods: Eight patients with suspected or confirmed melanoma underwent [99mTc]Tc-HYNIC-Octreotide imaging. Imaging findings were assessed visually using Krenning scores and quantitatively via lesion-to-liver uptake ratios. Histopathology served as the reference standard.
Results: Among seven histologically confirmed melanoma cases, six demonstrated radiotracer uptakes on SPECT/CT, though only four met the threshold for a positive scan (Krenning score ≥2). These four were classified as true positives, while the remaining three were false negatives. Quantitative analysis revealed that true-positive lesions had a significantly higher mean lesion-to-liver uptake ratio than false negatives (1.22 vs. 0.28; p = 0.009).
Conclusion: [99mTc]Tc-HYNIC-Octreotide scintigraphy demonstrates potential as a non-invasive tool for assessing SSTR expression in metastatic melanoma. This imaging approach may help identify patients who could benefit from SSTR-targeted therapies, particularly those unresponsive to conventional treatment. Further large-scale studies are warranted to validate these findings and explore the role of SSTR imaging in personalized melanoma management.

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