Somatostatin‐receptor Scintigraphy in Gastroenteropancreatic Tumors

Changing Treatment Strategy for Gastrinoma in Patients with Zollinger‐Ellison Syndrome

“…20 Almost all gastrinoma cells have somatostatin receptors, so SRS can detect not only gastrinomas around the pancreas, but also metastatic gastrinomas in the whole body. It is the most useful technique for detecting the ectopic gastrinoma.…”

“…By injecting the radiolabeled somatostatin analog intravenously, not only the main tumor but also metastatic tumors >2 cm can be visualized with SRS. 20 Somatostatin receptor scintigraphy is the most convenient and useful method to check the distribution of gastrinomas in the whole body of the patient. 12,20 However, because the sensitivity of SRS is correlated with the size of the gastrinoma, only 30% of gastrinomas <1 cm in diameter can be visualized by this technique.…”

“…20 Somatostatin receptor scintigraphy is the most convenient and useful method to check the distribution of gastrinomas in the whole body of the patient. 12,20 However, because the sensitivity of SRS is correlated with the size of the gastrinoma, only 30% of gastrinomas <1 cm in diameter can be visualized by this technique. Furthermore, SRS visualizes various kinds of gastropancreatic endocrine tumors only if they have somatostatin receptors, and the differential diagnosis of gastrinoma from other GEPET is difficult with SRS.…”

“…4,14 A new technique, the selective arterial secretagogue injection test (SASI test) with secretin or calcium and somatostatin receptor scintigraphy (SRS) represents the most reliable approach to localizing gastrinomas. [2][3][4][12][13][14][15][16][17][18][19][20] The guiding principle of the SASI test is localization of gastrinomas by demonstrating a feeding artery of the gastrinoma. This works because gastrinoma cells release gastrin when stimulated with secretin or calcium, both in vitro and in vivo.…”

“…6,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Incidence of lymph node metastases in patients with either duodenal or pancreatic gastrinomas has been reported to be greater than 40%. [19][20][21][22][23][24][25][26][27] The incidence of hepatic metastases has been reported to be more than 60% in patients with the pancreatic gastrinoma, although it has consistently been less than 10% in patients with duodenal gastrinoma. 11,[22][23][24][25][26][27] Liver metastases are a significant prognostic factor in patients with gastrinoma.…”