Multidetector computed tomography and neuroendocrine pancreaticoduodenal tumors

Rappeport, Eli D; Hansen, Carsten P.; Kjær, Andreas; Knigge, Ulrich

doi:10.1080/02841850600550716

Cited by 46 publications

(19 citation statements)

References 39 publications

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“…SRS was performed according to a previously described procedure (17). In brief, a dose of 166-269 MBq of 111 In-diethylenetriaminepentaacetic acid-octreotide (OctreoScan; Mallinckrodt) was injected intravenously.…”

Section: Srsmentioning

confidence: 99%

Functional Imaging of Neuroendocrine Tumors: A Head-to-Head Comparison of Somatostatin Receptor Scintigraphy, ¹²³I-MIBG Scintigraphy, and ¹⁸F-FDG PET

Binderup¹,

Knigge²,

Loft³

et al. 2010

J Nucl Med

255

166

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Functional techniques are playing a pivotal role in the imaging of cancer today. Our aim was to compare, on a head-to-head basis, 3 functional imaging techniques in patients with histologically verified neuroendocrine tumors: somatostatin receptor scintigraphy (SRS) with 111 In-diethylenetriaminepentaacetic acidoctreotide, scintigraphy with 123 I-metaiodobenzylguanidine (MIBG), and 18 F-FDG PET. Methods: Ninety-six prospectively enrolled patients with neuroendocrine tumors underwent SRS, 123 I-MIBG scintigraphy, and 18 F-FDG PET on average within 40 d. The functional images were fused with low-dose CT scans for anatomic localization, and the imaging results were compared with the proliferation index as determined by Ki67. Results: The overall sensitivity of SRS, 123 I-MIBG scintigraphy, and 18 F-FDG PET was 89%, 52%, and 58%, respectively. Of the 11 SRS-negative patients, 7 were 18 F-FDG PET-positive, of which 3 were also 123 I-MIBG scintigraphypositive, giving a combined overall sensitivity of 96%. SRS also exceeded 123 I-MIBG scintigraphy and 18 F-FDG PET based on the number of lesions detected (393, 185, and 225, respectively) and tumor subtypes. 123 I-MIBG scintigraphy was superior to 18 F-FDG PET for ileal neuroendocrine tumors, and 18 F-FDG PET was superior to 123 I-MIBG scintigraphy for pancreaticoduodenal neuroendocrine tumors. The sensitivity of 18 F-FDG PET (92%) exceeded that of both SRS (69%) and 123 I-MIBG scintigraphy (46%) for tumors with a proliferation index above 15%. Conclusion: The overall sensitivity of 123 I-MIBG scintigraphy and 18 F-FDG PET was low compared with SRS. However, for tumors with a high proliferation rate, 18 F-FDG PET had the highest sensitivity. The results indicate that, although SRS should still be the routine method, 18 F-FDG PET provides complementary diagnostic information and is of value for neuroendocrine tumor patients with negative SRS findings or a high proliferation index.

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Section: Srsmentioning

confidence: 99%

Functional Imaging of Neuroendocrine Tumors: A Head-to-Head Comparison of Somatostatin Receptor Scintigraphy, ¹²³I-MIBG Scintigraphy, and ¹⁸F-FDG PET

Binderup¹,

Knigge²,

Loft³

et al. 2010

J Nucl Med

255

166

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“…In a comparative study by Rappeport et al (22), CT detected 16 of 19 lesions (84.2%) and low-dose SPECT/CT 11 of 19 (57.9%). In our study also, the detection rate of diagnostic CT was superior to that of low-dose SPECT/CT (71.6% vs. 54.3% at 24 h and 55.6% at 48 h; Table 2), with the exception of pancreatic NENs (75% for lowdose SPECT/CT at 24 h vs. 58.3% for diagnostic CT; 83.3% for diagnostic SPECT/CT; Table 3; Fig.…”

Section: Discussionmentioning

confidence: 99%

Significance of a Single-Time-Point Somatostatin Receptor SPECT/Multiphase CT Protocol in the Diagnostic Work-up of Gastroenteropancreatic Neuroendocrine Neoplasms

et al. 2015

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This prospective study compared a 1-d SPECT/CT protocol with the commonly used 3-d protocol for somatostatin receptor scintigraphy in patients with gastroenteropancreatic neuroendocrine neoplasms. Additionally, the influence of SPECT/CT on patient management was evaluated. Methods: From October 2011 to October 2012, all gastroenteropancreatic neuroendocrine neoplasm patients undergoing restaging with somatostatin receptor scintigraphy on a modern SPECT/CT device were enrolled in this study. The protocol consisted of planar imaging at 4, 24, and 48 h; low-dose SPECT/CT at 24 and 48 h; diagnostic CT at 24 h using a triple-phase delay after administration of contrast; and diagnostic SPECT/CT at 24 h. All components of the imaging data were reassessed by 3 masked interpreters. The results were compared with a reference standard based on all clinical, imaging, and histopathology follow-up data available (follow-up range, 24-36 mo; mean, 29.9 mo). The reference standard was defined by a study-specific interdisciplinary tumor board that also reassessed treatment decisions. Results: Thirty-one patients were eligible for analysis (18 men and 13 women; mean age, 60.4 y). Ten had no imaging signs of disease and remained disease-free during follow-up. Twenty-one had persistent or recurrent disease (82 lesions: 24 in the liver, 21 in the lymph nodes, 16 in bone, 12 in the pancreas, and 9 in other locations). The respective lesion detection rates for interpreters 1, 2, and 3 were 51.9%, 49.4%, and 71.6% for low-dose SPECT/CT at 24 h; 51.9%, 55.6%, and 67.9% for low-dose SPECT/CT at 48 h; 63.0%, 70.4%, and 85.2% for diagnostic CT; and 77.8%, 84.0%, and 88.9% for diagnostic SPECT/CT. Interobserver agreement was moderate for diagnostic SPECT/CT (κ 5 0.44), diagnostic CT (κ 5 0.43), low-dose SPECT/CT at 48 h (κ 5 0.61), and low-dose SPECT/CT at 24 h (κ 5 0.55). For planar imaging, interobserver agreement was fair after 48 h (κ 5 0.36) and 24 h (κ 5 0.38) and moderate after 4 h (κ 5 0.42). Every lesion detectable on planar imaging or lowdose SPECT/CT was also detectable on diagnostic SPECT/CT. The CT and SPECT components of diagnostic SPECT/CT strongly complemented each other, as 34 of 82 lesions (41.4%) were detected on only the CT component or only the SPECT component. Therapeutic management was influenced by the diagnostic SPECT/CT interpretation in 8 of 31 patients (25.8%). Conclusion: The highest detection rates were achieved by diagnostic SPECT/CT. Thus, a more patient-friendly 1-d protocol is feasible. Furthermore, multiphase SPECT/CT affected management in about a quarter of patients.

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“…Various studies have shown a mean detection rate of 86% to 92% for IOUS detection of pancreatic neuroendocrine tumors [26,27] . In 2009 a consensus statement revealed a mean sensitivity and detection rate of pancreatic neuroendocrine tumors to be 63%-82% on CT [28,29] . Other studies evaluating pancreatic neuroendocrine tumors on MDCT have shown CT sensitivities of 84% and 94% [28,30] .…”

Section: Pancreasmentioning

confidence: 99%

“…In 2009 a consensus statement revealed a mean sensitivity and detection rate of pancreatic neuroendocrine tumors to be 63%-82% on CT [28,29] . Other studies evaluating pancreatic neuroendocrine tumors on MDCT have shown CT sensitivities of 84% and 94% [28,30] .…”

Section: Pancreasmentioning

confidence: 99%

Intraoperative abdominal ultrasound in oncologic imaging

Marcal

Patnana²,

Bhosale³

et al. 2013

WJR

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Significant advances in ultrasound technology have created new opportunities for its use in oncologic imaging. The advent of new transducers with focal beam technology and higher frequency has solidified the role of intraoperative sonography (IOUS) as an invaluable imaging modality in oncologic surgery of the liver, kidneys and pancreas. The ability to detect and characterize small lesions and the precise intraoperative localization of such tumors is essential for adequate surgical planning in segmental or lobar hepatic resections, metastasectomy, nephron-sparing surgery, and partial pancreatectomy. Also, diagnostic characterization of small equivocal lesions deemed indeterminate by conventional preoperative imaging such as multidetector computed tomography or magnetic resonance imaging, has become an important application of IOUS. This article will review the current applications of IOUS in the liver, kidneys and pancreas.

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Multidetector computed tomography and neuroendocrine pancreaticoduodenal tumors

Abstract: Dedicated MDCT of the pancreas can identify many NPTs, including small duodenal and periduodenal tumors, and the detection rate is better than reported in the older literature on CT.

Cited by 46 publications

References 39 publications

Functional Imaging of Neuroendocrine Tumors: A Head-to-Head Comparison of Somatostatin Receptor Scintigraphy, ¹²³I-MIBG Scintigraphy, and ¹⁸F-FDG PET

Functional Imaging of Neuroendocrine Tumors: A Head-to-Head Comparison of Somatostatin Receptor Scintigraphy, ¹²³I-MIBG Scintigraphy, and ¹⁸F-FDG PET

Significance of a Single-Time-Point Somatostatin Receptor SPECT/Multiphase CT Protocol in the Diagnostic Work-up of Gastroenteropancreatic Neuroendocrine Neoplasms

Intraoperative abdominal ultrasound in oncologic imaging

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Multidetector computed tomography and neuroendocrine pancreaticoduodenal tumors

Abstract: Dedicated MDCT of the pancreas can identify many NPTs, including small duodenal and periduodenal tumors, and the detection rate is better than reported in the older literature on CT.

Cited by 46 publications

References 39 publications

Functional Imaging of Neuroendocrine Tumors: A Head-to-Head Comparison of Somatostatin Receptor Scintigraphy, 123I-MIBG Scintigraphy, and 18F-FDG PET

Functional Imaging of Neuroendocrine Tumors: A Head-to-Head Comparison of Somatostatin Receptor Scintigraphy, 123I-MIBG Scintigraphy, and 18F-FDG PET

Significance of a Single-Time-Point Somatostatin Receptor SPECT/Multiphase CT Protocol in the Diagnostic Work-up of Gastroenteropancreatic Neuroendocrine Neoplasms

Intraoperative abdominal ultrasound in oncologic imaging

Contact Info

Product

Resources

About

Functional Imaging of Neuroendocrine Tumors: A Head-to-Head Comparison of Somatostatin Receptor Scintigraphy, ¹²³I-MIBG Scintigraphy, and ¹⁸F-FDG PET

Functional Imaging of Neuroendocrine Tumors: A Head-to-Head Comparison of Somatostatin Receptor Scintigraphy, ¹²³I-MIBG Scintigraphy, and ¹⁸F-FDG PET