Noninvasive imaging of insulinomas and gastrinomas with endoscopic ultrasonography and somatostatin receptor scintigraphy

Proye, C; Malvaux, P.; Pattou, François; Filoche, B; Godchaux, J. M.; Maunoury, V.; Palazzo, Laurent; Huglo, D.; Lefèbvre, J; Paris, J. C.

doi:10.1067/msy.1998.93109

Cited by 121 publications

(55 citation statements)

References 19 publications

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“…In addition, somatostatin receptors are not significantly expressed in non-malignant insulinomas further limiting SRS sensitivity [84] . However, malignant insulinomas are known to overexpress somatostatin receptors, and SRS has potential imaging roles in such tumors for prognostication and staging [85] . In contrast, gamma-based SRS has reported sensitivity and specificity for non-insulinoma pancreatic NETs of approximately 80%-90% [86,87] , and is indicated for use in pre-therapy localization and staging, especially when demonstration of extra-hepatic metastatic lesions is required.…”

Section: Functional Imaging Of Pancreatic Neuroendocrine Tumorsmentioning

confidence: 99%

Imaging of gastroenteropancreatic neuroendocrine tumors

Tan

Tan²

2011

WJCO

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Imaging of gastroenteropancreatic neuroendocrine tumors can be broadly divided into anatomic and functional techniques. Anatomic imaging determines the local extent of the primary lesion, providing crucial information required for surgical planning. Functional imaging, not only determines the extent of metastatic disease spread, but also provides important information with regard to the biologic behavior of the tumor, allowing clinicians to decide on the most appropriate forms of treatment. We review the current literature on this subject, with emphasis on the strengths of each imaging modality.

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Section: Functional Imaging Of Pancreatic Neuroendocrine Tumorsmentioning

confidence: 99%

Imaging of gastroenteropancreatic neuroendocrine tumors

Tan

Tan²

2011

WJCO

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“…Moreover, we recommend EUS immediately preoperatively because it permits better operative planification by detecting more precisely the number and extent of tumors and providing anatomic detail. 37,38 Octreoscan should be performed for biochemically proven lesions that are not shown by CT, for staging (distant metastasis) once a lesion is shown on CT, and preoperatively to rule out distant metastasis. The role of MRI is not clearly defined because its superiority over EUS for locoregional extension has not been clearly demonstrated.…”

Section: Diagnosis Of Nftpmentioning

confidence: 99%

Epidemiology Data on 108 MEN 1 Patients From the GTE With Isolated Nonfunctioning Tumors of the Pancreas

Triponez

Dosseh²,

Goudet³

et al. 2006

Annals of Surgery

223

256

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Objective: To analyze the penetrance and clinical course of isolated nonfunctioning tumors of the pancreas (NFTP) in MEN 1 patients, and to propose a strategy for managing them. Summary Background Data: Pancreaticoduodenal tumors develop in a majority of MEN 1 patients and are a major cause of death. The natural history of NFTP is poorly defined, and no clear-cut guidelines have been widely accepted regarding treatment. Methods: Data on 108 patients with isolated NFTP among 579 MEN 1 patients from the French Endocrine Tumor Study Group (GTE) were analyzed. Survival rates were calculated using the Kaplan-Meier method. Results: The penetrance of NFTP was 34% at age 50, making it the most frequent pancreaticoduodenal tumor in MEN 1 patients. Fortythree patients (40%) underwent surgery, 32 of them curatively. No patient died because of surgery. Average life expectancy for patients with NFTP was shorter than that for MEN 1 patients who did not have pancreaticoduodenal tumors. Thirteen patients died during follow-up, 10 due to NFTP. Tumor size was correlated with the risks of metastasis and death. These risks were low for patients with tumors Յ20 mm. Conclusions: NFTP are currently the most common tumors of the pancreaticoduodenal region in patients with MEN 1. Prevention of tumor spread by surgery should be balanced with potential operative mortality and morbidity. We do not recommend routine surgery for NFTP Յ20 mm. (Ann Surg 2006;243: 265-272) M ultiple endocrine neoplasia type 1 (MEN 1) is a rare autosomal dominant condition characterized by the development of endocrine parathyroid, pancreaticoduodenal, and pituitary tumors. In addition, MEN 1 patients are also prone to developing adrenal tumors, neuroendocrine tumors (in particular of the thymus or bronchus), dermal lesions, thyroid disease, and meningeal tumors. 1-7Pancreaticoduodenal tumors are often multiple, have been shown at autopsy to have developed in up to 80% of patients with MEN 1, and are a major cause of premature death in these patients. 8 -12 Most pancreaticoduodenal tumors are functioning tumors, the most frequent of which are gastrinomas and insulinomas, followed by the rare glucagonomas, VIPomas, GRFomas, and somatostatinomas. Surgical resection is the treatment of choice for functioning tumors of the pancreas, although controversy exists regarding the timing of surgery for gastrinomas. [13][14][15][16][17][18] In the absence of hormonal symptoms, nonfunctioning tumors of the pancreas (NFTP) have been recognized as a separate entity whose penetrance in the MEN 1 population is not well known. 19,20 In addition, because large surgical series of patients presenting with isolated NFTP are lacking and few clinical series have followed patients with NFTP, no clear-cut treatment guidelines have been widely accepted. Some authors have recommended a conservative approach for asymptomatic NFTP less than 1, 2, or 3 cm. [21][22][23][24] Others have recommended early surgical excision of all tumors as soon as they are found on imaging studies, or even ea...

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“…A recent single-centre prospective study showed a sensitivity of 93% and a specificity of 95% in localization of intra-pancreatic lesions. EUS could detect all tumors visualized by every other conventional technique, thus questioning the need for the rest imaging modalities (Figure 6-8) [44][45][46][47][48]. CT scan showing an insulinoma (white dot pointed to by yellow arrow) in the body of the pancreas (P with arrows pointing to the body and tail of the pancreas).…”

Section: Endoscopic Ultrasoundmentioning

confidence: 99%

Insulinoma: Literature’s Review (2)

AlJadir¹

2015

EMIJ

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Noninvasive imaging of insulinomas and gastrinomas with endoscopic ultrasonography and somatostatin receptor scintigraphy

Cited by 121 publications

References 19 publications

Imaging of gastroenteropancreatic neuroendocrine tumors

Imaging of gastroenteropancreatic neuroendocrine tumors

Epidemiology Data on 108 MEN 1 Patients From the GTE With Isolated Nonfunctioning Tumors of the Pancreas

Insulinoma: Literature’s Review (2)

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