title: Screening of pancreaticoduodenal endocrine tumours in patients with MEN 1: multidetector-row computed tomography vs. endoscopic ultrasound.
abstract: OBJECTIVE
  The authors compared multidetector-row computed tomography (MDCT) and endoscopic ultrasound (EUS) in the identification of pancreaticoduodenal endocrine tumours (PETs) in patients with multiple endocrine neoplasia type 1 (MEN 1).
  
  
  METHODS
  Fourteen consecutive patients (eight men and six women, aged 26-54 years) with MEN 1 underwent MDCT performed with a 4- (n=5) or 64- (n=9) detector-row system and EUS done with a radial transducer (7.5-20 MHz) within 7-28 days of each other. Prior to MDCT examination, patients were given 750 cc of water and asked to lie down in the right lateral decubitus for 15 min. Multiphase MDCT images were acquired both before and after the injection of nonionic iodinated contrast material (2 cc/kg) at an injection rate of 4 ml/s, with technical parameters and scan delay varying in relation to the system used. Images were all reconstructed at 3-mm intervals for the three phases (arterial, pancreatic and portal) and evaluated on a dedicated workstation.
  
  
  RESULTS
  MDCT detected a total of 25 PETs (3-18 mm) in nine patients. Of these lesions, nine were situated within the duodenal wall and 16 in either the pancreatic head (n=3), body (n=7), or tail (n=6). Three additional lesions were detected retrospectively after EUS imaging. Most (18/22, 81%) were hypervascular nodules, and four appeared as either hypoattenuating or cystic lesions. EUS detected a total of 32 PETs (2-18 mm) in 11 patients. Most lesions (29/32, 90%) appeared hypoechoic and were situated in the duodenal wall (n=15) or in either the pancreatic head (n=10), body (n=6) or tail (n=1).
  
  
  CONCLUSIONS
  Our preliminary data indicate that MDCT is complementary to EUS in the identification of PETs in MEN-1 patients.
authors.affiliation: Dipartimento di Scienze Bio-Morfologiche e Funzionali, Sez. di Diagnostica per Immagini e Radioterapia (Ed. 10), Università degli Studi di Napoli Federico II, Via S. Pansini 5, 80131, Napoli, Italy. camera@unina.it
authors.forename: L
authors.initials: L
authors.lastname: Camera
authors.forename: S
authors.initials: S
authors.lastname: Paoletta
authors.forename: C
authors.initials: C
authors.lastname: Mollica
authors.forename: F
authors.initials: F
authors.lastname: Milone
authors.forename: V
authors.initials: V
authors.lastname: Napolitano
authors.forename: L
authors.initials: L
authors.lastname: De Luca
authors.forename: A
authors.initials: A
authors.lastname: Faggiano
authors.forename: A
authors.initials: A
authors.lastname: Colao
authors.forename: M
authors.initials: M
authors.lastname: Salvatore
mesh_terms: D000328:Adult; D004379:Duodenal Neoplasms / Q000000981:diagnostic imaging*; D004386:Duodenum / Q000000981:diagnostic imaging; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000000981:diagnostic imaging*; D010179:Pancreas / Q000000981:diagnostic imaging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed