Preoperative localization of gastrointestinal endocrine tumors using somatostatin-receptor scintigraphy.
OBJECTIVE
The purpose of this study was to determine the value of somatostatin-receptor scintigraphy (SRS) in the preoperative localization of gastrointestinal endocrine tumors. The authors report their preliminary experiences with this new technique as compared to conventional imaging studies like computed tomography (CT) and ultrasonography (US).


BACKGROUND
Most endocrine tumors possess high-affinity somatostatin-receptors. Using the stable, 111Indium labelled somatostatin analogue pentatreotid, which binds to these receptors, it is possible to detect somatostatin-receptor-positive tumors scintigraphically.


METHODS
In nine patients with various gastrointestinal endocrine tumors, SRS, CT, and US were performed before surgical exploration. The preoperative imaging studies and intraoperative ultrasound (IOUS) were then compared to findings on surgical exploration.


RESULTS
Twelve primary tumors were found in 8 patients at surgical exploration. These primary tumors were correctly identified with SRS in five patients, with US in four patients, and with CT in three patients. In one patient with the Zollinger-Ellison syndrome, scintigraphy suggested a tumor in the area of the hepatoduodenal ligament, while CT and US had negative results. The underlying gastrinoma could not be identified despite extensive surgical exploration. Scintigraphy, CT, and US showed comparable results in the detection of metastases in four patients.


CONCLUSIONS
The data from this small series suggest that SRS is helpful in the preoperative localization of gastrointestinal endocrine tumors.
Weinel
R J
RJ
Department of Surgery, University-Hospital, Phillips-University Marburg, Germany.
Neuhaus
C
C
Stapp
J
J
Klotter
H J
HJ
Trautmann
M E
ME
Joseph
K
K
Arnold
R
R
Rothmund
M
M
D000328:Adult; D000368:Aged; D004701:Endocrine Gland Neoplasms / Q000000981:diagnostic imaging*; D005188:False Negative Reactions; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D007205:Indium Radioisotopes; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011877:Radionuclide Imaging / Q000379:methods; D017481:Receptors, Somatostatin / Q000032:analysis*; D013004:Somatostatin / Q000031:analogs & derivatives; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D007205:Indium Radioisotopes; D017481:Receptors, Somatostatin; D013004:Somatostatin