title: [Value of endoscopic ultrasonography and somatostatin receptor scintigraphy in the preoperative localization of insulinomas and gastrinomas. Experience of 54 cases].
abstract: OBJECTIVE
  The classic morphological techniques for the localization of insulinomas and gastrinomas are of limited value. Endoscopic ultrasonography and somatostatin receptor scintigraphy have shown high sensitivity for the detection of gastroenteropancreatic endocrine tumors. The aim of the study was to evaluate the sensitivity of endoscopic ultrasonography and that of somatostatin receptor scintigraphy in the localization of insulinomas and gastrinomas.
  
  
  METHODS
  This retrospective study concerned 54 patients with insulinoma (n=29) or gastrinoma (n=26) operated on between March 1991 and March 2000 and who had at least one among the two tested examinations. Forty-two patients had scintigraphy (17 with insulinoma, 25 with gastrinoma), 47 had endoscopic ultrasonography (28 with insulinoma, 17 with gastrinoma). One of the ten patients with MEN 1 had both tumors. All diagnosis were confirmed by histologic examination.
  
  
  RESULTS
  The sensitivity of scintigraphy for the localization of insulinomas was 47%. There was one false positive. Sensitivity of endoscopic ultrasonography for insulinomas was 85%. The sensitivity of scintigraphy in the detection of gastrinomas was 65% for the tumors in the duodenopancreatic area, 20% for the tumors in the pancreatic tail and 71% for metastasis. The sensitivity of endoscopic ultrasonography was 46% for duodenal tumors, 75% for pancreatic tumors and 57% for lymph node metastasis. The combination of both localization studies increased sensitivity to 94%.
  
  
  CONCLUSIONS
  Endoscopic ultrasonography and somatostatin receptor scintigraphy are the gold standard for localization of gastrinomas. Association of both examinations increases the sensitivity. Scintigraphy for the detection of insulinomas should be performed when endoscopic ultrasonography is negative.
authors.affiliation: Service de Chirurgie Générale et Endocrinienne, Clinique Chirurgicale Adultes Est, Hopital Claude Huriez, CHU Lille, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Mirallié
authors.forename: François
authors.initials: F
authors.lastname: Pattou
authors.forename: Philippe
authors.initials: P
authors.lastname: Malvaux
authors.forename: Bernard
authors.initials: B
authors.lastname: Filoche
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Godchaux
authors.forename: Vincent
authors.initials: V
authors.lastname: Maunoury
authors.forename: Laurent
authors.initials: L
authors.lastname: Palazzo
authors.forename: Jean
authors.initials: J
authors.lastname: Lefebvre
authors.forename: Damien
authors.initials: D
authors.lastname: Huglo
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Paris
authors.forename: Bruno
authors.initials: B
authors.lastname: Carnaille
authors.forename: Charles
authors.initials: C
authors.lastname: Proye
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004379:Duodenal Neoplasms / Q000000981:diagnostic imaging; D019160:Endosonography; D005260:Female; D015408:Gastrinoma / Q000000981:diagnostic imaging*; D006801:Humans; D007340:Insulinoma / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D017481:Receptors, Somatostatin / Q000032:analysis*; D012189:Retrospective Studies
chemical_list: D017481:Receptors, Somatostatin
vernacular_title: Valeurs de l'échoendoscopie et de la scintigraphie des récepteurs de la somatostatine dans la localisation pré-opératoire des insulinomes et gastrinomes.