BACKGROUND & AIMS: Recently [111In-DTPA-D-Phe1]-octreotide was approved for somatostatin receptor scintigraphy (SRS) of gastroenteropancreatic tumors. SRS and other tumor localization methods can be time consuming, expensive, and involve patient inconvenience. The role of SRS in comparison to other tumor localization modalities remains undefined because the relative effects of these methods on management have not been studied. The aim of this study was to determine whether SRS alters clinical management in Zollinger-Ellison syndrome. METHODS: One hundred twenty-two consecutive patients were studied prospectively. Each patient was assigned to one of five different clinical categories. Conventional imaging studies (ultrasonography, computerized tomography, magnetic resonance image, angiography, and bone scan) were performed, and the management was proposed. SRS was then performed. Clinical management was reassessed, and whether SRS altered management was determined based on six criteria. RESULTS: SRS was superior to any single imaging study. SRS altered management in 47% overall and in 22%-60% of patients in the five different clinical categories. Primary tumor localization and clarification of equivocal localization results from conventional studies were the principal reasons for altering management. SRS was equally useful in patients with or without metastatic liver disease. CONCLUSIONS: Because of the ability of SRS to alter clinical management combined with its superior sensitivity, high specificity, simplicity, and cost-effectiveness, SRS should be the initial imaging modality for patients with gastrinomas.
BACKGROUND & AIMS: Recently [111In-DTPA-D-Phe1]-octreotide was approved for somatostatin receptor scintigraphy (SRS) of gastroenteropancreatic tumors. SRS and other tumor localization methods can be time consuming, expensive, and involve patient inconvenience. The role of SRS in comparison to other tumor localization modalities remains undefined because the relative effects of these methods on management have not been studied. The aim of this study was to determine whether SRS alters clinical management in Zollinger-Ellison syndrome. METHODS: One hundred twenty-two consecutive patients were studied prospectively. Each patient was assigned to one of five different clinical categories. Conventional imaging studies (ultrasonography, computerized tomography, magnetic resonance image, angiography, and bone scan) were performed, and the management was proposed. SRS was then performed. Clinical management was reassessed, and whether SRS altered management was determined based on six criteria. RESULTS:SRS was superior to any single imaging study. SRS altered management in 47% overall and in 22%-60% of patients in the five different clinical categories. Primary tumor localization and clarification of equivocal localization results from conventional studies were the principal reasons for altering management. SRS was equally useful in patients with or without metastatic liver disease. CONCLUSIONS: Because of the ability of SRS to alter clinical management combined with its superior sensitivity, high specificity, simplicity, and cost-effectiveness, SRS should be the initial imaging modality for patients with gastrinomas.
Authors: Matthew H Kulke; Lowell B Anthony; David L Bushnell; Wouter W de Herder; Stanley J Goldsmith; David S Klimstra; Stephen J Marx; Janice L Pasieka; Rodney F Pommier; James C Yao; Robert T Jensen Journal: Pancreas Date: 2010-08 Impact factor: 3.327
Authors: J K Ramage; A H G Davies; J Ardill; N Bax; M Caplin; A Grossman; R Hawkins; A M McNicol; N Reed; R Sutton; R Thakker; S Aylwin; D Breen; K Britton; K Buchanan; P Corrie; A Gillams; V Lewington; D McCance; K Meeran; A Watkinson Journal: Gut Date: 2005-06 Impact factor: 23.059
Authors: Jeffrey A Norton; Douglas L Fraker; H R Alexander; Fathia Gibril; David J Liewehr; David J Venzon; Robert T Jensen Journal: Ann Surg Date: 2006-09 Impact factor: 12.969
Authors: Scott H Long; Marc J Berna; Michelle Thill; Andrea Pace; Tapas K Pradhan; K Martin Hoffmann; Jose Serrano; Robert T Jensen Journal: J Clin Endocrinol Metab Date: 2007-08-21 Impact factor: 5.958
Authors: H R Alexander; D L Fraker; J A Norton; D L Bartlett; L Tio; S B Benjamin; J L Doppman; S U Goebel; J Serrano; F Gibril; R T Jensen Journal: Ann Surg Date: 1998-08 Impact factor: 12.969
Authors: Jeffrey A Norton; H Richard Alexander; Douglas L Fraker; David J Venzon; Fathia Gibril; Robert T Jensen Journal: Ann Surg Date: 2004-05 Impact factor: 12.969
Authors: Damian Wild; Jörg S Schmitt; Mihaela Ginj; Helmut R Mäcke; Bert F Bernard; Eric Krenning; Marion De Jong; Sandra Wenger; Jean-Claude Reubi Journal: Eur J Nucl Med Mol Imaging Date: 2003-08-21 Impact factor: 9.236