Imaging of neuroendocrine tumors: accuracy of helical CT versus SRS.
BACKGROUND
We retrospectively compared the accuracy of somatostatin receptor scintigraphy (SRS) with that of helical computed tomography (CT) in the detection and localization of primary and metastatic neuroendocrine tumors.


METHODS
A medical record search identified 27 patients with known or clinically suspected neuroendocrine tumors who underwent helical CT and SRS within 3 months of one another at our institution. CT images were evaluated retrospectively by two blinded radiologists who used consensus reading. Images were evaluated for the presence or absence of primary tumor and hepatic and extrahepatic metastases. CT results were compared with the SRS report as interpreted by the nuclear medicine physicians. The results of the surgical, clinical follow-up, and pathologic findings were considered as the gold standard. Sensitivity, specificity, and accuracy were calculated for both imaging techniques. In addition, McNemar analysis was performed to determine statistically significant differences between CT and SRS.


RESULTS
Helical CT was more sensitive than SRS in the detection of extrahepatic metastases, and the difference between the two imaging modalities was statistically significant (p = 0.0312) as determined by the McNemar chi-square test. However, the difference between CT and SRS in detecting primary neuroendocrine tumors, hepatic metastasis, and combined hepatic and extrahepatic metastasis was not statistically significant (p = 0.625, 1.000, and 1.000, respectively).


CONCLUSIONS
Helical CT and SRS have similar sensitivity, specificity, and accuracy in detecting primary neuroendocrine tumor and hepatic metastasis. However, helical CT appears to be more sensitive in detecting extrahepatic metastasis from primary neuroendocrine tumors.
Kumbasar
B
B
Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, 601 North Caroline Street, Baltimore, MD 21287, USA.
Kamel
I R
IR
Tekes
A
A
Eng
J
J
Fishman
E K
EK
Wahl
R L
RL
D007516:Adenoma, Islet Cell / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D007414:Intestinal Neoplasms / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000556:secondary; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D017481:Receptors, Somatostatin / Q000032:analysis*; D012680:Sensitivity and Specificity; D013004:Somatostatin / Q000031:analogs & derivatives*; D036542:Tomography, Spiral Computed
D007205:Indium Radioisotopes; D017481:Receptors, Somatostatin; D013004:Somatostatin; C081788:pentetreotide