title: The influence of somatostatin receptor scintigraphy during preoperative staging of non-functioning pancreatic neuroendocrine tumours.
abstract: OBJECTIVE
  To determine whether somatostatin receptor scintigraphy (SRS) influences the preoperative staging and clinical management of non-functioning pancreatic neuroendocrine tumours (NF-pNETs).
  
  
  METHODS
  All SRS examinations performed between 2002-2013 were selected. Patients with NF-pNET were included if both computed tomography (CT) and SRS was performed during preoperative staging. The diagnostic accuracy of CT and SRS for detecting NF-pNET metastases was analysed. Altered TNM classification and changed clinical management were calculated. Changed management was defined as a change from surgical resection into systemic treatment or vice versa. NF-pNETs were defined as tumours without clinical symptoms of hormonal hypersecretion.
  
  
  RESULTS
  Overall, 62 patients with NF-pNET were included with a mean age of 57 years (SD: 12.4)(2). In 28 patients (45%), CT and SRS were correct and in agreement in the detection of primary tumour/metastases. In 34 patients (55%), one of the techniques was incorrect and therefore, there was no agreement. SRS altered the TNM classification in 14 patients (23%) and clinical management in nine patients (15%). In patients without metastases on CT, SRS detected lymph node metastases in one patient. The sensitivity to detect the primary tumour with CT was 95% and with SRS was 73%. In detecting metastases, the sensitivity and specificity were both 85% for CT versus 80% and 90% for SRS.
  
  
  CONCLUSIONS
  Overall, CT and SRS were in agreement in the detection of NF-pNET. In NF-pNET without suspicious metastatic lesions on CT, SRS has limited value. SRS may be indicated to confirm lesions suspicious for neuroendocrine tumours metastases.
authors.affiliation: Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands. Electronic address: a.p.jilesen@amc.uva.nl.
authors.forename: A P J
authors.initials: AP
authors.lastname: Jilesen
authors.affiliation: Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: S J M
authors.initials: SJ
authors.lastname: Hoefnagel
authors.affiliation: Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: O R C
authors.initials: OR
authors.lastname: Busch
authors.affiliation: Department of Nuclear Medicine, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: R J
authors.initials: RJ
authors.lastname: Bennink
authors.affiliation: Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: D J
authors.initials: DJ
authors.lastname: Gouma
authors.affiliation: Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: E J M
authors.initials: EJ
authors.lastname: Nieveen van Dijkum
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000556:secondary; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000556:secondary*; D011300:Preoperative Care / Q000379:methods; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D017481:Receptors, Somatostatin / Q000378:metabolism*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013004:Somatostatin / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin; D013004:Somatostatin; C081788:pentetreotide