ldtЛучевая диагностика и терапияDiagnostic radiology and radiotherapy2079-5343Baltic Medical Education Center10.22328/2079-5343-2023-14-4-19-27ldt-935Research ArticleОБЗОРЫREVIEWSРадиоизотопная диагностика эндогенного АКТГ-зависимого гиперкортицизма: обзорRadioisotope diagnostics of endogenous ACTH-dependent hypercorticism: a reviewhttps://orcid.org/0000-0001-9732-7920ХорошавинаА. А.KhoroshavinaА. А.

Хорошавина Алина Алексеевна — клинический ординатор кафедры ядерной медицины и радиационных технологий с клиникой Института медицинского образования

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Alina A. Khoroshavina — resident of the Department of Nuclear Medicine and Radiation Technologies with the clinic of the Institute of Medical Education

197341, St. Petersburg, st. Akkuratova, d. 2

horoshavina-lina-yan@ya.ruhttps://orcid.org/0009-0005-0902-1347ОрловаГ. А.OrlovaG. A.

Орлова Галина Анатольевна — врач-радиолог отделения радиологии Университетской клиники

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Galina A. Orlova — Nuclear medicine physician, Department of Nuclear medicine of University Clinic

197341, St. Petersburg, st. Akkuratova, d. 2

orlova_ga@almazovceentre.ruhttps://orcid.org/0000-0002-7086-9153РыжковаД. В.RyzhkovaD. V.

Рыжкова Дарья Викторовна — доктор медицинских наук, профессор РАН, заведующая кафедрой ядерной медицины и радиационных технологий с клиникой Института медицинского образования, главный научный сотрудник научно-исследовательского отдела ядерной медицины и тераностики

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Daria V. Ryzhkova — Dr. of Sci. (Med.), Professor of the Russian Academy of Sciences, Head of the Department of Nuclear Medicine and Radiation Technologies with a clinic of the Institute of Medical Education, Chief Researcher of the Research Department of Nuclear Medicine and Theranostics

197341, St. Petersburg, st. Akkuratova, d. 2

d_ryjkova@mail.ruНациональный медицинский исследовательский центр имени В. А. АлмазоваРоссияAlmazov National Medical Research CentreRussian Federation2023160120241441927Copyright © Хорошавина А.А., Орлова Г.А., Рыжкова Д.В., 20242024Хорошавина А.А., Орлова Г.А., Рыжкова Д.В.Khoroshavina А.А., Orlova G.A., Ryzhkova D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://radiag.bmoc-spb.ru/jour/article/view/935

ВВЕДЕНИЕ: В обзоре литературы представлены возможности существующих методов радионуклидной диагностики эндогенного АКТГ-зависимого гиперкортицизма, к которому относятся болезнь Иценко–Кушинга и эктопический АКТГ-синдром. Схожая клиническая картина этих патологий значительно затрудняет их дифференциальную диагностику. Сложности также вызывает локализация кортикотропиномы, особенно у пациентов с персистирующей болезнью Кушинга, и эктопического очага гиперпродукции АКТГ.ЦЕЛЬ: Анализ имеющейся иностранной и отечественной литературы для определения возможностей методов радионуклидной визуализации в диагностике эндогенного АКТГ-зависимого гиперкортицизма.МАТЕРИАЛЫ И МЕТОДЫ: Проведен поиск научных публикаций и клинических рекомендаций в информационно-аналитических системах PudMed, elibrary за последние двадцать лет, посвященных диагностике болезни Иценко–Кушинга и эктопического АКТГ-синдрома с помощью методов радиоизотопной диагностики по ключевым словам «болезнь Иценко– Кушинга», «эктопический АКТГ-синдром», «радионуклидная диагностика», «сцинтиграфия», «ОФЭКТ», «ПЭТ».РЕЗУЛЬТАТЫ: Представленный обзор продемонстрировал широкие возможности и перспективы использования современных радиоизотопных методов визуализации в диагностике эндогенного АКТГ-зависимого гиперкортицизма. Методы радионуклидной визуализации позволяют провести исследование в режиме «всё тело», что дает возможность в рамках одного исследования обнаружить не только первичный опухолевый очаг, но и метастазы у пациентов с эктопическим АКТГ-синдромом. Помимо этого, использование сцинтиграфии или позитронно-эмиссионной томографии с мечеными аналогами соматостатина дает возможность спрогнозировать эффективность лечения образований, продуцирующих адренокортикотропный гормон, аналогами соматостатина, что важно при планировании противоопухолевой терапии.ЗАКЛЮЧЕНИЕ: Применение методов радиоизотопной диагностики существенно повышает точность топической диагностики опухолевого очага, позволяет провести оценку распространенности опухолевого процесса и отбор пациентов для противоопухолевой терапии с использованием аналогов соматостатина.

INTRODUCTION: The literature review presents the possibilities of existing methods of radionuclide diagnosis of endogenous ACTH-dependent hypercorticism, which includes Itsenko-Cushing’s disease and ectopic ACTH syndrome. The similar clinical picture of these pathologies significantly complicates their differential diagnosis. Localization of corticotropinoma, especially in patients with persistent Cushing’s disease, and ectopic focus of ACTH hyperproduction also causes difficulties.OBJECTIVE: To analyze the available foreign and domestic literature to determine the possibilities of radionuclide imaging methods in the diagnosis of endogenous ACTH-dependent hypercorticism.MATERIALS AND METHODS: A search of scientifiс publications and clinical recommendations in the information and analytical systems PudMed and elibrary over the past twenty years, dedicated to the diagnosis of Itsenko-Cushing’s disease and ectopic ACTH syndrome using radioisotope diagnostic methods by keywords «Itsenko-Cushing’s disease», «ectopic ACTH syndrome», «radionuclide diagnostics», «scintigraphy», «SPECT», «PET».RESULTS: The presented review demonstrated the broad possibilities and prospects of using modern radioisotope imaging methods in the diagnosis of endogenous ACTH-dependent hypercorticism. Radionuclide imaging methods make it possible to conduct a study in the «whole body» mode, which makes it possible to detect not only the primary tumor focus, but also metastases in patients with ectopic ACTH syndrome in one study. In addition, the use of scintigraphy or positron emission tomography with labeled somatostatin analogues makes it possible to predict the effectiveness of treatment of formations producing adrenocorticotropic hormone with somatostatin analogues, which is important when planning antitumor therapy.CONCLUSION: The use of radioisotope diagnostic methods significantly increases the accuracy of topical diagnosis of a tumor focus, allows for an assessment of the prevalence of the tumor process and the selection of patients for antitumor therapy using somatostatin analogues.

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The authors declare that there are no conflicts of interest present.