Krenning score of neuroendocrine tumor uptake
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The Krenning score is a proposed semi-quantitative method of assessing the degree of tracer uptake on octreotide scintigraphy.
Parameters
Initially designed for assessment of 111In-DTPA on planar imaging, the Krenning score is applicable to SPECT or SPECT/CT as well as various radiopharmaceuticals.
Determination of the Krenning score requires comparison to the liver and spleen (or kidney if not applicable).
Relative uptake score
- 0:
Nonenone - 1:
Muchmuch lower than liver - 2:
Slightlyslightly less than or equal to liver - 3:
Greatergreater than liver - 4:
Greatergreater than spleen
Important points
- the commonest contemporary application of the Krenning score is to assess candidacy for peptide receptor radionuclide therapy (PRRT), such as 177Lu-DOTATATE, usually with a score greater than 2.
- false positive localization in general for somatostatin scintigraphy may be as high as 12% and thus scoring and interpretation should take place in the appropriate clinical context (e.g. serum chromogranin A, urine 5-HIAA, and tumour grade).
- the scale has shown potential for use in other somatostatin receptor imaging modalities such as 68Ga-DOTATATE PET/CT 2.
History and etymology
The notion of grading neuroendocrine tumour uptake was introduced by Eric Krenning, a Dutch physician, who led whole-body efforts into somatostatin receptor imaging 1.
-<li>0: None</li>-<li>1: Much lower than liver</li>-<li>2: Slightly less than or equal to liver </li>-<li>3: Greater than liver</li>-<li>4: Greater than spleen</li>- +<li>0: none</li>
- +<li>1: much lower than liver</li>
- +<li>2: slightly less than or equal to liver </li>
- +<li>3: greater than liver</li>
- +<li>4: greater than spleen</li>
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