Management of metastatic endocrine tumours

Plöckinger, Ursula; Wiedenmann, Bertram

doi:10.1016/j.bpg.2005.02.013

Cited by 32 publications

(16 citation statements)

References 157 publications

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“…By xenografting AR42J cells in an orthotopic pancreatic location, we were able to more accurately model important clinical features of the human pancreatic NETs [22]: (1) growth of large tumor masses within the pancreatic region; (2) invasive tumor growth; (3) nodal spread, and (4) peritoneal dissemination. With respect to the imaging applications, this implemented two major improvements:…”

Section: Discussionmentioning

confidence: 99%

An Orthotopic Model of Pancreatic Somatostatin Receptor (SSTR)-Positive Tumors Allows Bimodal Imaging Studies Using 3T MRI and Animal PET-Based Molecular Imaging of SSTR Expression

et al. 2007

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Somatostatin receptor (SSTR) scintigraphy is currently used as one standard imaging modality in neuroendocrine tumors (NETs). However, future optimization of NET imaging may be achieved with positron emission tomography based methods utilizing more sensitive and specific tracers in combination with computed tomography or magnetic resonance imaging. Here we established an orthotopic mouse model that reflects relevant aspects of human pancreatic NETs such as SSTR expression, dense vascularization and metastatic disease. This model was then utilized to test the feasibility of combined magnetic resonance imaging and animal positron emission tomography. Orthotopic implantation of amphicrine, SSTR-positive pancreatic AR42J cells resulted in rapidly growing tumors, with concomitant metastatic spread into abdominal lymph nodes and peritoneal cavity. Primary tumors as well as their metastases expressed the neuroendocrine markers chromogranin A and synaptophysin. For imaging experiments, the SSTR ligands ⁶⁸Ga-DOTATOC or ⁶⁸Ga-DOTANOC were injected intravenously, and animals were subsequently examined in an animal positron emission tomography scanner and a clinical 3T (tesla) magnetic resonance imager. All animals showed radionuclide accumulation in the primary tumor. Definite anatomical correlation was achieved using digital image fusion of the positron emission tomography and magnetic resonance imaging data. ⁶⁸Ga-DOTANOC strongly accumulated in the tumor tissue (mean 6.6-fold vs. control tissues) when compared to ⁶⁸Ga-DOTATOC, which showed a higher renal clearance. In good agreement with the biodistribution data, the kidney-to-tumor ratio was higher for ⁶⁸Ga-DOTATOC (2.43-fold vs. 1.75-fold). Consequently, ⁶⁸Ga-DOTANOC achieved better signal enhancement in the primary tumor and allowed for detection of metastatic lesions. In summary, we established a novel orthotopic pancreatic SSTR-positive tumor model and used this model to provide proof of principle for the diagnostic combination of SSTR-based molecular imaging and magnetic resonance imaging. Specifically, the animal model allowed the comparative evaluation of ⁶⁸Ga-DOTANOC and ⁶⁸Ga-DOTATOC, with ⁶⁸Ga-DOTANOC providing better tumor-specific accumulation and renal activity. We conclude that this animal model will be of innovative value for further investigation in the imaging of NETs.

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Section: Discussionmentioning

confidence: 99%

An Orthotopic Model of Pancreatic Somatostatin Receptor (SSTR)-Positive Tumors Allows Bimodal Imaging Studies Using 3T MRI and Animal PET-Based Molecular Imaging of SSTR Expression

et al. 2007

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“…One fourth of ZES patients have tumors that demonstrate aggressive growth and progress to cause death while in the remaining 75% the tumor growth is indolent and death from tumor is uncommon [6, 19]. Cytoreductive surgery, chemotherapy, hepatic artery embolization or chemo-embolization, biotherapy (somatostatin analogues/interferon), peptide receptor radionuclide therapy and liver transplantation have all been recommended as valuable in ZES patients with advanced disease [74,75,76]. …”

Section: Integrated Therapy Of Advanced Diseasementioning

confidence: 99%

Gastrinoma (Duodenal and Pancreatic)

Jensen¹,

et al. 2006

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“…In der klinischen Praxis werden diese Tumoren mittlerweile aufgrund des weit verbreiteten Einsatzes von Computertomographie und Magnetresonanztomographie zunehmend häufiger entdeckt. Werden diese Tumoren jedoch aufgrund der fehlenden Symptomatik durch Hormonexzess erst durch Spätsymptome wie Druckgefühl im Oberbauch, Ikterus und Schmerzen diagnostiziert, handelt es sich meist um große (>5 cm) maligne nfNPT, die sich aus Sicht der Autoren nicht mehr für ein laparoskopisches Vorgehen eignen, insbesondere im Hinblick auf die erforderliche subtile Lymphadenektomie [4].…”

Section: Nichtfunktionelle Nptunclassified

“…VIPome ("vasoactive intestinal peptide-producing tumors") machen etwa 8% aus, die Prävalenz von Glukagonomen, PPomen ("pancreatic polypeptide-producing tumors") und Somatostatinomen liegt unter 2% [1]. Etwa 60-80% der Gastrinome, 10% der Insulinome sowie 70% der übrigen NPT sind maligne [4]. In 10-20% der Fälle sind NPT mit der multiplen endokrinen Neoplasie Typ 1 (MEN-1), einem autosomal-dominant vererbten Tumorsyndrom, assoziiert.…”

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Minimal-invasive Resektion neuroendokriner Pankreastumoren

Langer

Fendrich

Bartsch

2008

Chirurg

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Pancreatic endocrine tumors (PET) are a heterogeneous group of lesions with an annual incidence of 0.1 to 0.4 per 100,000. They account for 2-4% of pancreatic neoplasms. Due to their mostly small size, some are suited to a laparoscopic approach. Preoperative localization, intraoperative laparoscopic ultrasonography, and considerable experience in pancreatic endocrine surgery and sophisticated laparoscopic techniques are essential for successful laparoscopic treatment of these tumors. If definite or highly suspicious signs of malignancy occur, a conventional open approach should be preferred. Insulinomas and small nonfunctioning PET in the pancreatic body or tail or near the surface of the pancreatic head and not in contact with the portal vein or the main pancreatic duct are suited to a laparoscopic approach. Patients with MEN1 who have insulinomas or small nonfunctioning PET may also benefit from a laparoscopic spleen-preserving distal pancreatic resection. Neither sporadic and MEN1-associated gastrinomas nor the very rare glucagonomas and vasoactive intestinal peptide-producing tumors (vipomas), which are often large and malignant, should also be tackled laparoscopically.

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Management of metastatic endocrine tumours

Cited by 32 publications

References 157 publications

An Orthotopic Model of Pancreatic Somatostatin Receptor (SSTR)-Positive Tumors Allows Bimodal Imaging Studies Using 3T MRI and Animal PET-Based Molecular Imaging of SSTR Expression

An Orthotopic Model of Pancreatic Somatostatin Receptor (SSTR)-Positive Tumors Allows Bimodal Imaging Studies Using 3T MRI and Animal PET-Based Molecular Imaging of SSTR Expression

Gastrinoma (Duodenal and Pancreatic)

Minimal-invasive Resektion neuroendokriner Pankreastumoren

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