Staging of digestive endocrine tumours using helical computed tomography and somatostatin receptor scintigraphy.
BACKGROUND
In patients with digestive endocrine tumours, complete pre-operative staging is essential in planning proper management and evaluating treatment efficacy. To date, somatostatin receptor scintigraphy (SRS) is considered the 'gold standard' imaging procedure, and very few data are available concerning the use of helical computed tomography (hCT). This study aimed to determine the diagnostic accuracy and the ability to modify the surgical management of hCT, alone or combined with SRS.


METHODS
Sixty patients were staged before surgery by hCT, SRS and tumour markers, and included in group 1 if suitable for radical surgery, otherwise in group 2. All patients underwent laparotomy followed by subsequent re-staging.


RESULTS
SRS sensitivity was 77%, 48% and 67% for primary, lymph-node and liver lesions, respectively. hCT sensitivity was 94%, 69% and 94% for primary, lymph-node and liver lesions, respectively (P = 0.02 versus SRS, for liver lesions). During pre-operative evaluation, hCT correctly staged 92% and SRS 75% of patients (P = 0.02). hCT provided additional information in 17% of patients.


CONCLUSIONS
Since hCT has been shown to be extremely accurate, providing essential information for the planning of surgical treatment compared with that of SRS, both techniques should be used in the pre-operative work-up of digestive endocrine tumours.
Panzuto
F
F
Department of Digestive and Liver Disease, University La Sapienza, Roma, Italy.
Falconi
M
M
Nasoni
S
S
Angeletti
S
S
Moretti
A
A
Bezzi
M
M
Gualdi
G
G
Polettini
E
E
Sciuto
R
R
Festa
A
A
Scopinaro
F
F
Corleto
V D
VD
Bordi
C
C
Pederzoli
P
P
Delle Fave
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D004701:Endocrine Gland Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging / Q000379:methods*; D010347:Patient Care Planning; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011877:Radionuclide Imaging / Q000379:methods; D017481:Receptors, Somatostatin / Q000032:analysis*; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed
D014408:Biomarkers, Tumor; D017481:Receptors, Somatostatin