Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1993 Nov;218(5):640–645. doi: 10.1097/00000658-199321850-00009

Preoperative localization of gastrointestinal endocrine tumors using somatostatin-receptor scintigraphy.

R J Weinel 1, C Neuhaus 1, J Stapp 1, H J Klotter 1, M E Trautmann 1, K Joseph 1, R Arnold 1, M Rothmund 1
PMCID: PMC1243035  PMID: 7902072

Abstract

OBJECTIVE: The purpose of this study was to determine the value of somatostatin-receptor scintigraphy (SRS) in the preoperative localization of gastrointestinal endocrine tumors. The authors report their preliminary experiences with this new technique as compared to conventional imaging studies like computed tomography (CT) and ultrasonography (US). SUMMARY BACKGROUND DATA: Most endocrine tumors possess high-affinity somatostatin-receptors. Using the stable, 111Indium labelled somatostatin analogue pentatreotid, which binds to these receptors, it is possible to detect somatostatin-receptor-positive tumors scintigraphically. METHODS: In nine patients with various gastrointestinal endocrine tumors, SRS, CT, and US were performed before surgical exploration. The preoperative imaging studies and intraoperative ultrasound (IOUS) were then compared to findings on surgical exploration. RESULTS: Twelve primary tumors were found in 8 patients at surgical exploration. These primary tumors were correctly identified with SRS in five patients, with US in four patients, and with CT in three patients. In one patient with the Zollinger-Ellison syndrome, scintigraphy suggested a tumor in the area of the hepatoduodenal ligament, while CT and US had negative results. The underlying gastrinoma could not be identified despite extensive surgical exploration. Scintigraphy, CT, and US showed comparable results in the detection of metastases in four patients. CONCLUSIONS: The data from this small series suggest that SRS is helpful in the preoperative localization of gastrointestinal endocrine tumors.

Full text

PDF
640

Images in this article

643Figure 1.
on p.643
644Figure 2.
on p.644
644Figure 3.
on p.644

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andersen D. K. Current diagnosis and management of Zollinger-Ellison syndrome. Ann Surg. 1989 Dec;210(6):685–703. doi: 10.1097/00000658-198912000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Arnold R., Neuhaus C., Benning R., Schwerk W. B., Trautmann M. E., Joseph K., Bruns C. Somatostatin analog sandostatin and inhibition of tumor growth in patients with metastatic endocrine gastroenteropancreatic tumors. World J Surg. 1993 Jul-Aug;17(4):511–519. doi: 10.1007/BF01655111. [DOI] [PubMed] [Google Scholar]
  3. Bakker W. H., Albert R., Bruns C., Breeman W. A., Hofland L. J., Marbach P., Pless J., Pralet D., Stolz B., Koper J. W. [111In-DTPA-D-Phe1]-octreotide, a potential radiopharmaceutical for imaging of somatostatin receptor-positive tumors: synthesis, radiolabeling and in vitro validation. Life Sci. 1991;49(22):1583–1591. doi: 10.1016/0024-3205(91)90052-d. [DOI] [PubMed] [Google Scholar]
  4. Bakker W. H., Albert R., Bruns C., Breeman W. A., Hofland L. J., Marbach P., Pless J., Pralet D., Stolz B., Koper J. W. [111In-DTPA-D-Phe1]-octreotide, a potential radiopharmaceutical for imaging of somatostatin receptor-positive tumors: synthesis, radiolabeling and in vitro validation. Life Sci. 1991;49(22):1583–1591. doi: 10.1016/0024-3205(91)90052-d. [DOI] [PubMed] [Google Scholar]
  5. Büchler M., Friess H., Klempa I., Hermanek P., Sulkowski U., Becker H., Schafmayer A., Baca I., Lorenz D., Meister R. Role of octreotide in the prevention of postoperative complications following pancreatic resection. Am J Surg. 1992 Jan;163(1):125–131. doi: 10.1016/0002-9610(92)90264-r. [DOI] [PubMed] [Google Scholar]
  6. Gerich J. E., Patton G. S. Somatostatin. Physiology and clinical applications. Med Clin North Am. 1978 Mar;62(2):375–392. doi: 10.1016/s0025-7125(16)31813-2. [DOI] [PubMed] [Google Scholar]
  7. Krenning E. P., Bakker W. H., Breeman W. A., Koper J. W., Kooij P. P., Ausema L., Lameris J. S., Reubi J. C., Lamberts S. W. Localisation of endocrine-related tumours with radioiodinated analogue of somatostatin. Lancet. 1989 Feb 4;1(8632):242–244. doi: 10.1016/s0140-6736(89)91258-0. [DOI] [PubMed] [Google Scholar]
  8. Lamberts S. W., Bakker W. H., Reubi J. C., Krenning E. P. Somatostatin-receptor imaging in the localization of endocrine tumors. N Engl J Med. 1990 Nov 1;323(18):1246–1249. doi: 10.1056/NEJM199011013231805. [DOI] [PubMed] [Google Scholar]
  9. Norton J. A., Doppman J. L., Jensen R. T. Curative resection in Zollinger-Ellison syndrome. Results of a 10-year prospective study. Ann Surg. 1992 Jan;215(1):8–18. doi: 10.1097/00000658-199201000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Reichlin S. Somatostatin (second of two parts). N Engl J Med. 1983 Dec 22;309(25):1556–1563. doi: 10.1056/NEJM198312223092506. [DOI] [PubMed] [Google Scholar]
  11. Reichlin S. Somatostatin. N Engl J Med. 1983 Dec 15;309(24):1495–1501. doi: 10.1056/NEJM198312153092406. [DOI] [PubMed] [Google Scholar]
  12. Reubi J. C., Häcki W. H., Lamberts S. W. Hormone-producing gastrointestinal tumors contain a high density of somatostatin receptors. J Clin Endocrinol Metab. 1987 Dec;65(6):1127–1134. doi: 10.1210/jcem-65-6-1127. [DOI] [PubMed] [Google Scholar]
  13. Reubi J. C., Krenning E., Lamberts S. W., Kvols L. Somatostatin receptors in malignant tissues. J Steroid Biochem Mol Biol. 1990 Dec 20;37(6):1073–1077. doi: 10.1016/0960-0760(90)90468-z. [DOI] [PubMed] [Google Scholar]
  14. Reubi J. C., Kvols L. K., Waser B., Nagorney D. M., Heitz P. U., Charboneau J. W., Reading C. C., Moertel C. Detection of somatostatin receptors in surgical and percutaneous needle biopsy samples of carcinoids and islet cell carcinomas. Cancer Res. 1990 Sep 15;50(18):5969–5977. [PubMed] [Google Scholar]
  15. Reubi J. C., Lang W., Maurer R., Koper J. W., Lamberts S. W. Distribution and biochemical characterization of somatostatin receptors in tumors of the human central nervous system. Cancer Res. 1987 Nov 1;47(21):5758–5764. [PubMed] [Google Scholar]
  16. Rothmund M., Angelini L., Brunt L. M., Farndon J. R., Geelhoed G., Grama D., Herfarth C., Kaplan E. L., Largiader F., Morino F. Surgery for benign insulinoma: an international review. World J Surg. 1990 May-Jun;14(3):393–399. doi: 10.1007/BF01658536. [DOI] [PubMed] [Google Scholar]
  17. Schally A. V. Oncological applications of somatostatin analogues. Cancer Res. 1988 Dec 15;48(24 Pt 1):6977–6985. [PubMed] [Google Scholar]
  18. Schally A. V., Srkalovic G., Szende B., Redding T. W., Janaky T., Juhasz A., Korkut E., Cai R. Z., Szepeshazi K., Radulovic S. Antitumor effects of analogs of LH-RH and somatostatin: experimental and clinical studies. J Steroid Biochem Mol Biol. 1990 Dec 20;37(6):1061–1067. doi: 10.1016/0960-0760(90)90466-x. [DOI] [PubMed] [Google Scholar]
  19. Vinik A. I., McLeod M. K., Fig L. M., Shapiro B., Lloyd R. V., Cho K. Clinical features, diagnosis, and localization of carcinoid tumors and their management. Gastroenterol Clin North Am. 1989 Dec;18(4):865–896. [PubMed] [Google Scholar]
  20. Wise S. R., Johnson J., Sparks J., Carey L. C., Ellison E. C. Gastrinoma: the predictive value of preoperative localization. Surgery. 1989 Dec;106(6):1087–1093. [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES