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. 1997 Sep-Dec;70(5-6):481–500.

Definition of the role of somatostatin receptor scintigraphy in gastrointestinal neuroendocrine tumor localization.

R T Jensen 1, F Gibril 1, B Termanini 1
PMCID: PMC2589266  PMID: 9825476

Abstract

There are six major steps in the management of patients with neuroendocrine tumors (NETs) (carcinoids and pancreatic endocrine tumors). One of the steps that is increasing in its importance is the need to assess primary tumor location and tumor extent in these patients. Without such information, it is not possible to adequately manage these patients. Conventional imaging studies (CT scan, MRI, ultrasound, angiography), functional localization studies measuring hormonal gradients, endoscopic ultrasound, and most recently, somatostatin receptor scintigraphy (SRS) with [125I-DTPA-DPhe1]-octreotide have all been advocated to localize NETs in different studies. Whereas it is now established that for all NETs, except insulinomas, SRS has the greatest sensitivity, it remains unclear whether this increased sensitivity translates into increased clinical usefulness. It, therefore, remains unclear based on fiscal and clinical considerations what should be the recommended algorithm for the use of the different localization methods. To address this issue, we have recently performed two prospective studies on patients with gastrinomas. In this paper, the methods and results of each are summarized and based on these results, an algorithm for localization studies in NETs is proposed. One study assessed the role of SRS in management in 122 patients and shows that the use of SRS changed management in 47 percent of patients according to six different criteria when the patients were stratified according to their principal management problem. Determining whether liver metastases were present is one of the major goals of tumor localization studies and is frequently a source of confusion because of the difficulty in distinguishing small NETs liver metastases from hemangiomas. In the second study, the ability of SRS and other tumor localization methods to distinguish these two possibilities was assessed in 15 patients with small hemangiomas and 15 patients with small hepatic metastases (mean size 1.3 cm). SRS correctly identified 93 percent of the patients with liver metastases and was not positive in any patient with a hemangioma, suggesting it was not a liver metastases. SRS had greater negative and positive predictive value than conventional studies. Based on these two studies, and SRS's greater sensitivity and fiscal considerations, it is proposed that SRS should be the initial tumor imaging study in all NETs except insulinomas, and algorithms for the use of other localization studies in both NETs and insulinomas are proposed.

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Selected References

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  1. Bechstein W. O., Neuhaus P. Liver transplantation for hepatic metastases of neuroendocrine tumors. Ann N Y Acad Sci. 1994 Sep 15;733:507–514. doi: 10.1111/j.1749-6632.1994.tb17301.x. [DOI] [PubMed] [Google Scholar]
  2. Becker W., Schrell U., Buchfelder M., Hensen J., Wendler J., Gramatzki M., Wolf F. Somatostatin receptor expression in the thyroid demonstrated with 111In-octreotide scintigraphy. Nuklearmedizin. 1995 Jun;34(3):100–103. [PubMed] [Google Scholar]
  3. Birnbaum B. A., Weinreb J. C., Megibow A. J., Sanger J. J., Lubat E., Kanamuller H., Noz M. E., Bosniak M. A. Definitive diagnosis of hepatic hemangiomas: MR imaging versus Tc-99m-labeled red blood cell SPECT. Radiology. 1990 Jul;176(1):95–101. doi: 10.1148/radiology.176.1.2191377. [DOI] [PubMed] [Google Scholar]
  4. Bonanno N., Baldari S., Cerrito A., Zimbaro G., Restifo G., Blandino A., Freni O. Diagnosis of hepatic hemangiomas with 99mTc-labeled red blood cell scanning: value of SPECT. J Nucl Biol Med. 1991 Jul-Sep;35(3):135–140. [PubMed] [Google Scholar]
  5. Cadiot G., Lebtahi R., Sarda L., Bonnaud G., Marmuse J. P., Vissuzaine C., Ruszniewski P., Le Guludec D., Mignon M. Preoperative detection of duodenal gastrinomas and peripancreatic lymph nodes by somatostatin receptor scintigraphy. Groupe D'etude Du Syndrome De Zollinger-Ellison. Gastroenterology. 1996 Oct;111(4):845–854. doi: 10.1016/s0016-5085(96)70052-5. [DOI] [PubMed] [Google Scholar]
  6. Carty S. E., Jensen R. T., Norton J. A. Prospective study of aggressive resection of metastatic pancreatic endocrine tumors. Surgery. 1992 Dec;112(6):1024–1032. [PubMed] [Google Scholar]
  7. Dai W., Shi Y., Cai L. [Report of a case of glucagonoma misdiagnosed as "eczema" and "hepatic angioma" for three years and review of literature]. Zhonghua Nei Ke Za Zhi. 1995 Mar;34(3):190–192. [PubMed] [Google Scholar]
  8. Doppman J. L., Chang R., Fraker D. L., Norton J. A., Alexander H. R., Miller D. L., Collier E., Skarulis M. C., Gorden P. Localization of insulinomas to regions of the pancreas by intra-arterial stimulation with calcium. Ann Intern Med. 1995 Aug 15;123(4):269–273. doi: 10.7326/0003-4819-123-4-199508150-00004. [DOI] [PubMed] [Google Scholar]
  9. Doppman J. L., Miller D. L., Chang R., Shawker T. H., Gorden P., Norton J. A. Insulinomas: localization with selective intraarterial injection of calcium. Radiology. 1991 Jan;178(1):237–241. doi: 10.1148/radiology.178.1.1984311. [DOI] [PubMed] [Google Scholar]
  10. Doppman J. L., Shawker T. H., Miller D. L. Localization of islet cell tumors. Gastroenterol Clin North Am. 1989 Dec;18(4):793–804. [PubMed] [Google Scholar]
  11. Farlow D. C., Little J. M., Gruenewald S. M., Antico V. F., O'Neill P. A case of metastatic malignancy masquerading as a hepatic hemangioma on labeled red blood cell scintigraphy. J Nucl Med. 1993 Jul;34(7):1172–1174. [PubMed] [Google Scholar]
  12. Fishbeyn V. A., Norton J. A., Benya R. V., Pisegna J. R., Venzon D. J., Metz D. C., Jensen R. T. Assessment and prediction of long-term cure in patients with the Zollinger-Ellison syndrome: the best approach. Ann Intern Med. 1993 Aug 1;119(3):199–206. doi: 10.7326/0003-4819-119-3-199308010-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Freeny P. C., Marks W. M. Hepatic hemangioma: dynamic bolus CT. AJR Am J Roentgenol. 1986 Oct;147(4):711–719. doi: 10.2214/ajr.147.4.711. [DOI] [PubMed] [Google Scholar]
  14. Frucht H., Norton J. A., London J. F., Vinayek R., Doppman J. L., Gardner J. D., Jensen R. T., Maton P. N. Detection of duodenal gastrinomas by operative endoscopic transillumination. A prospective study. Gastroenterology. 1990 Dec;99(6):1622–1627. doi: 10.1016/0016-5085(90)90466-e. [DOI] [PubMed] [Google Scholar]
  15. Gibril F., Doppman J. L., Chang R., Weber H. C., Termanini B., Jensen R. T. Metastatic gastrinomas: localization with selective arterial injection of secretin. Radiology. 1996 Jan;198(1):77–84. doi: 10.1148/radiology.198.1.8539410. [DOI] [PubMed] [Google Scholar]
  16. Gibril F., Reynolds J. C., Doppman J. L., Chen C. C., Venzon D. J., Termanini B., Weber H. C., Stewart C. A., Jensen R. T. Somatostatin receptor scintigraphy: its sensitivity compared with that of other imaging methods in detecting primary and metastatic gastrinomas. A prospective study. Ann Intern Med. 1996 Jul 1;125(1):26–34. doi: 10.7326/0003-4819-125-1-199607010-00005. [DOI] [PubMed] [Google Scholar]
  17. Hammond P. J., Arka A., Peters A. M., Bloom S. R., Gilbey S. G. Localization of metastatic gastroenteropancreatic tumours by somatostatin receptor scintigraphy with [111In-DTPA-D-Phe1]-octreotide. Q J Med. 1994 Feb;87(2):83–88. [PubMed] [Google Scholar]
  18. Ishak K. G., Rabin L. Benign tumors of the liver. Med Clin North Am. 1975 Jul;59(4):995–1013. doi: 10.1016/s0025-7125(16)31998-8. [DOI] [PubMed] [Google Scholar]
  19. Itai Y., Ohtomo K., Araki T., Furui S., Iio M., Atomi Y. Computed tomography and sonography of cavernous hemangioma of the liver. AJR Am J Roentgenol. 1983 Aug;141(2):315–320. doi: 10.2214/ajr.141.2.315. [DOI] [PubMed] [Google Scholar]
  20. Itai Y., Ohtomo K., Furui S., Yamauchi T., Minami M., Yashiro N. Noninvasive diagnosis of small cavernous hemangioma of the liver: advantage of MRI. AJR Am J Roentgenol. 1985 Dec;145(6):1195–1199. doi: 10.2214/ajr.145.6.1195. [DOI] [PubMed] [Google Scholar]
  21. Jamar F., Fiasse R., Leners N., Pauwels S. Somatostatin receptor imaging with indium-111-pentetreotide in gastroenteropancreatic neuroendocrine tumors: safety, efficacy and impact on patient management. J Nucl Med. 1995 Apr;36(4):542–549. [PubMed] [Google Scholar]
  22. Jensen R. T. Gastrin-producing tumors. Cancer Treat Res. 1997;89:293–334. doi: 10.1007/978-1-4615-6355-6_14. [DOI] [PubMed] [Google Scholar]
  23. Johnson C. M., Sheedy P. F., 2nd, Stanson A. W., Stephens D. H., Hattery R. R., Adson M. A. Computed tomography and angiography of cavernous hemangiomas of the liver. Radiology. 1981 Jan;138(1):115–121. doi: 10.1148/radiology.138.1.7455071. [DOI] [PubMed] [Google Scholar]
  24. Joseph K., Stapp J., Reinecke J., Skamel H. J., Höffken H., Neuhaus C., Lenze H., Trautmann M. E., Arnold R. Receptor scintigraphy with 111In-pentetreotide for endocrine gastroenteropancreatic tumors. Horm Metab Res Suppl. 1993;27:28–35. [PubMed] [Google Scholar]
  25. Karhunen P. J. Benign hepatic tumours and tumour like conditions in men. J Clin Pathol. 1986 Feb;39(2):183–188. doi: 10.1136/jcp.39.2.183. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Kisker O., Weinel R. J., Geks J., Zacara F., Joseph K., Rothmund M. Value of somatostatin receptor scintigraphy for preoperative localization of carcinoids. World J Surg. 1996 Feb;20(2):162–167. doi: 10.1007/s002689900025. [DOI] [PubMed] [Google Scholar]
  27. Klöppel G., Heitz P. U. Classification of normal and neoplastic neuroendocrine cells. Ann N Y Acad Sci. 1994 Sep 15;733:19–23. doi: 10.1111/j.1749-6632.1994.tb17252.x. [DOI] [PubMed] [Google Scholar]
  28. Krenning E. P., Kwekkeboom D. J., Bakker W. H., Breeman W. A., Kooij P. P., Oei H. Y., van Hagen M., Postema P. T., de Jong M., Reubi J. C. Somatostatin receptor scintigraphy with [111In-DTPA-D-Phe1]- and [123I-Tyr3]-octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med. 1993 Aug;20(8):716–731. doi: 10.1007/BF00181765. [DOI] [PubMed] [Google Scholar]
  29. Krenning E. P., Kwekkeboom D. J., Oei H. Y., de Jong R. J., Dop F. J., Reubi J. C., Lamberts S. W. Somatostatin-receptor scintigraphy in gastroenteropancreatic tumors. An overview of European results. Ann N Y Acad Sci. 1994 Sep 15;733:416–424. doi: 10.1111/j.1749-6632.1994.tb17291.x. [DOI] [PubMed] [Google Scholar]
  30. Krenning E. P., Kwekkeboom D. J., Reubi J. C., van Hagen P. M., van Eijck C. H., Oei H. Y., Lamberts S. W. 111In-octreotide scintigraphy in oncology. Digestion. 1993;54 (Suppl 1):84–87. doi: 10.1159/000201083. [DOI] [PubMed] [Google Scholar]
  31. Kvols L. K. Somatostatin-receptor imaging of human malignancies: a new era in the localization, staging, and treatment of tumors. Gastroenterology. 1993 Dec;105(6):1909–1911. doi: 10.1016/0016-5085(93)91091-u. [DOI] [PubMed] [Google Scholar]
  32. Langley K. The neuroendocrine concept today. Ann N Y Acad Sci. 1994 Sep 15;733:1–17. doi: 10.1111/j.1749-6632.1994.tb17251.x. [DOI] [PubMed] [Google Scholar]
  33. Leslie D. F., Johnson C. D., Johnson C. M., Ilstrup D. M., Harmsen W. S. Distinction between cavernous hemangiomas of the liver and hepatic metastases on CT: value of contrast enhancement patterns. AJR Am J Roentgenol. 1995 Mar;164(3):625–629. doi: 10.2214/ajr.164.3.7863883. [DOI] [PubMed] [Google Scholar]
  34. Li K. C., Glazer G. M., Quint L. E., Francis I. R., Aisen A. M., Ensminger W. D., Bookstein F. L. Distinction of hepatic cavernous hemangioma from hepatic metastases with MR imaging. Radiology. 1988 Nov;169(2):409–415. doi: 10.1148/radiology.169.2.3174988. [DOI] [PubMed] [Google Scholar]
  35. MacFarlane M. P., Fraker D. L., Alexander H. R., Norton J. A., Lubensky I., Jensen R. T. Prospective study of surgical resection of duodenal and pancreatic gastrinomas in multiple endocrine neoplasia type 1. Surgery. 1995 Dec;118(6):973–980. doi: 10.1016/s0039-6060(05)80102-3. [DOI] [PubMed] [Google Scholar]
  36. McLoughlin M. J. Angiography in cavernous hemangioma of the liver. Am J Roentgenol Radium Ther Nucl Med. 1971 Sep;113(1):50–55. doi: 10.2214/ajr.113.1.50. [DOI] [PubMed] [Google Scholar]
  37. Moriura S., Ikeda S., Hirai M., Naiki K., Fujioka T., Yokochi K., Gotou S. Hepatic gastrinoma. Cancer. 1993 Sep 1;72(5):1547–1550. doi: 10.1002/1097-0142(19930901)72:5<1547::aid-cncr2820720510>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  38. Norton J. A., Cromack D. T., Shawker T. H., Doppman J. L., Comi R., Gorden P., Maton P. N., Gardner J. D., Jensen R. T. Intraoperative ultrasonographic localization of islet cell tumors. A prospective comparison to palpation. Ann Surg. 1988 Feb;207(2):160–168. doi: 10.1097/00000658-198802000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Norton J. A., Doppman J. L., Collen M. J., Harmon J. W., Maton P. N., Gardner J. D., Jensen R. T. Prospective study of gastrinoma localization and resection in patients with Zollinger-Ellison syndrome. Ann Surg. 1986 Oct;204(4):468–479. doi: 10.1097/00000658-198610000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Norton J. A. Neuroendocrine tumors of the pancreas and duodenum. Curr Probl Surg. 1994 Feb;31(2):77–156. doi: 10.1016/0011-3840(94)90079-5. [DOI] [PubMed] [Google Scholar]
  41. Norton J. A., Shawker T. H., Doppman J. L., Miller D. L., Fraker D. L., Cromack D. T., Gorden P., Jensen R. T. Localization and surgical treatment of occult insulinomas. Ann Surg. 1990 Nov;212(5):615–620. doi: 10.1097/00000658-199011000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Norton J. A., Sugarbaker P. H., Doppman J. L., Wesley R. A., Maton P. N., Gardner J. D., Jensen R. T. Aggressive resection of metastatic disease in selected patients with malignant gastrinoma. Ann Surg. 1986 Apr;203(4):352–359. doi: 10.1097/00000658-198604000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. O'Shea D., Rohrer-Theurs A. W., Lynn J. A., Jackson J. E., Bloom S. R. Localization of insulinomas by selective intraarterial calcium injection. J Clin Endocrinol Metab. 1996 Apr;81(4):1623–1627. doi: 10.1210/jcem.81.4.8636378. [DOI] [PubMed] [Google Scholar]
  44. Oberg K. The use of chemotherapy in the management of neuroendocrine tumors. Endocrinol Metab Clin North Am. 1993 Dec;22(4):941–952. [PubMed] [Google Scholar]
  45. Palazzo L., Roseau G., Salmeron M. Endoscopic ultrasonography in the preoperative localization of pancreatic endocrine tumors. Endoscopy. 1992 May;24 (Suppl 1):350–353. doi: 10.1055/s-2007-1010498. [DOI] [PubMed] [Google Scholar]
  46. Pauwels S., Leners N., Fiasse R., Jamar F. Localization of gastroenteropancreatic neuroendocrine tumors with 111indium-pentetreotide scintigraphy. Semin Oncol. 1994 Oct;21(5 Suppl 13):15–20. [PubMed] [Google Scholar]
  47. Pisegna J. R., Doppman J. L., Norton J. A., Metz D. C., Jensen R. T. Prospective comparative study of ability of MR imaging and other imaging modalities to localize tumors in patients with Zollinger-Ellison syndrome. Dig Dis Sci. 1993 Jul;38(7):1318–1328. doi: 10.1007/BF01296084. [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Pollard J. J., Fleischli D. J., Nebesar R. A. Angiography of hepatic neoplasms. Radiol Clin North Am. 1970 Apr;8(1):31–41. [PubMed] [Google Scholar]
  49. Que F. G., Nagorney D. M., Batts K. P., Linz L. J., Kvols L. K. Hepatic resection for metastatic neuroendocrine carcinomas. Am J Surg. 1995 Jan;169(1):36–43. doi: 10.1016/s0002-9610(99)80107-x. [DOI] [PubMed] [Google Scholar]
  50. Quinn S. F., Benjamin G. G. Hepatic cavernous hemangiomas: simple diagnostic sign with dynamic bolus CT. Radiology. 1992 Feb;182(2):545–548. doi: 10.1148/radiology.182.2.1732978. [DOI] [PubMed] [Google Scholar]
  51. Reubi J. C., Horisberger U., Laissue J. High density of somatostatin receptors in veins surrounding human cancer tissue: role in tumor-host interaction? Int J Cancer. 1994 Mar 1;56(5):681–688. doi: 10.1002/ijc.2910560513. [DOI] [PubMed] [Google Scholar]
  52. Reubi J. C., Laissue J., Waser B., Horisberger U., Schaer J. C. Expression of somatostatin receptors in normal, inflamed, and neoplastic human gastrointestinal tissues. Ann N Y Acad Sci. 1994 Sep 15;733:122–137. doi: 10.1111/j.1749-6632.1994.tb17262.x. [DOI] [PubMed] [Google Scholar]
  53. Reubi J. C., Mazzucchelli L., Laissue J. A. Intestinal vessels express a high density of somatostatin receptors in human inflammatory bowel disease. Gastroenterology. 1994 Apr;106(4):951–959. doi: 10.1016/0016-5085(94)90754-4. [DOI] [PubMed] [Google Scholar]
  54. Ruszniewski P., Amouyal P., Amouyal G., Grangé J. D., Mignon M., Bouché O., Bernades P. Localization of gastrinomas by endoscopic ultrasonography in patients with Zollinger-Ellison syndrome. Surgery. 1995 Jun;117(6):629–635. doi: 10.1016/s0039-6060(95)80005-0. [DOI] [PubMed] [Google Scholar]
  55. Rösch T., Lightdale C. J., Botet J. F., Boyce G. A., Sivak M. V., Jr, Yasuda K., Heyder N., Palazzo L., Dancygier H., Schusdziarra V. Localization of pancreatic endocrine tumors by endoscopic ultrasonography. N Engl J Med. 1992 Jun 25;326(26):1721–1726. doi: 10.1056/NEJM199206253262601. [DOI] [PubMed] [Google Scholar]
  56. Scherübl H., Bäder M., Fett U., Hamm B., Schmidt-Gayk H., Koppenhagen K., Dop F. J., Riecken E. O., Wiedenmann B. Somatostatin-receptor imaging of neuroendocrine gastroenteropancreatic tumors. Gastroenterology. 1993 Dec;105(6):1705–1709. doi: 10.1016/0016-5085(93)91066-q. [DOI] [PubMed] [Google Scholar]
  57. Service F. J., Dale A. J., Elveback L. R., Jiang N. S. Insulinoma: clinical and diagnostic features of 60 consecutive cases. Mayo Clin Proc. 1976 Jul;51(7):417–429. [PubMed] [Google Scholar]
  58. Sheppard B. C., Norton J. A., Doppman J. L., Maton P. N., Gardner J. D., Jensen R. T. Management of islet cell tumors in patients with multiple endocrine neoplasia: a prospective study. Surgery. 1989 Dec;106(6):1108–1118. [PubMed] [Google Scholar]
  59. Soyer P., Gueye C., Somveille E., Laissy J. P., Scherrer A. MR diagnosis of hepatic metastases from neuroendocrine tumors versus hemangiomas: relative merits of dynamic gadolinium chelate-enhanced gradient-recalled echo and unenhanced spin-echo images. AJR Am J Roentgenol. 1995 Dec;165(6):1407–1413. doi: 10.2214/ajr.165.6.7484575. [DOI] [PubMed] [Google Scholar]
  60. Stefanini P., Carboni M., Patrassi N., Basoli A. Beta-islet cell tumors of the pancreas: results of a study on 1,067 cases. Surgery. 1974 Apr;75(4):597–609. [PubMed] [Google Scholar]
  61. Sugg S. L., Norton J. A., Fraker D. L., Metz D. C., Pisegna J. R., Fishbeyn V., Benya R. V., Shawker T. H., Doppman J. L., Jensen R. T. A prospective study of intraoperative methods to diagnose and resect duodenal gastrinomas. Ann Surg. 1993 Aug;218(2):138–144. doi: 10.1097/00000658-199308000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Termanini B., Gibril F., Doppman J. L., Reynolds J. C., Stewart C. A., Sutliff V. E., Venzon D. J., Jensen R. T. Distinguishing small hepatic hemangiomas from vascular liver metastases in gastrinoma: use of a somatostatin-receptor scintigraphic agent. Radiology. 1997 Jan;202(1):151–158. doi: 10.1148/radiology.202.1.8988205. [DOI] [PubMed] [Google Scholar]
  63. Termanini B., Gibril F., Reynolds J. C., Doppman J. L., Chen C. C., Stewart C. A., Sutliff V. E., Jensen R. T. Value of somatostatin receptor scintigraphy: a prospective study in gastrinoma of its effect on clinical management. Gastroenterology. 1997 Feb;112(2):335–347. doi: 10.1053/gast.1997.v112.pm9024287. [DOI] [PubMed] [Google Scholar]
  64. Thom A. K., Norton J. A., Doppman J. L., Miller D. L., Chang R., Jensen R. T. Prospective study of the use of intraarterial secretin injection and portal venous sampling to localize duodenal gastrinomas. Surgery. 1992 Dec;112(6):1002–1009. [PubMed] [Google Scholar]
  65. Thompson N. W., Czako P. F., Fritts L. L., Bude R., Bansal R., Nostrant T. T., Scheiman J. M. Role of endoscopic ultrasonography in the localization of insulinomas and gastrinomas. Surgery. 1994 Dec;116(6):1131–1138. [PubMed] [Google Scholar]
  66. Valkema R., Steens J., Cleton F. J., Pauwels E. K. The diagnostic utility of somatostatin receptor scintigraphy in oncology. J Cancer Res Clin Oncol. 1996;122(9):513–532. doi: 10.1007/BF01213548. [DOI] [PubMed] [Google Scholar]
  67. Vanhagen P. M., Krenning E. P., Reubi J. C., Kwekkeboom D. J., Bakker W. H., Mulder A. H., Laissue I., Hoogstede H. C., Lamberts S. W. Somatostatin analogue scintigraphy in granulomatous diseases. Eur J Nucl Med. 1994 Jun;21(6):497–502. doi: 10.1007/BF00173035. [DOI] [PubMed] [Google Scholar]
  68. Vanhagen P. M., Markusse H. M., Lamberts S. W., Kwekkeboom D. J., Reubi J. C., Krenning E. P. Somatostatin receptor imaging. The presence of somatostatin receptors in rheumatoid arthritis. Arthritis Rheum. 1994 Oct;37(10):1521–1527. doi: 10.1002/art.1780371017. [DOI] [PubMed] [Google Scholar]
  69. Weinel R. J., Neuhaus C., Stapp J., Klotter H. J., Trautmann M. E., Joseph K., Arnold R., Rothmund M. Preoperative localization of gastrointestinal endocrine tumors using somatostatin-receptor scintigraphy. Ann Surg. 1993 Nov;218(5):640–645. doi: 10.1097/00000658-199321850-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  70. Zimmer T., Stölzel U., Bäder M., Koppenhagen K., Hamm B., Buhr H., Riecken E. O., Wiedenmann B. Endoscopic ultrasonography and somatostatin receptor scintigraphy in the preoperative localisation of insulinomas and gastrinomas. Gut. 1996 Oct;39(4):562–568. doi: 10.1136/gut.39.4.562. [DOI] [PMC free article] [PubMed] [Google Scholar]
  71. Zimmer T., Ziegler K., Bäder M., Fett U., Hamm B., Riecken E. O., Wiedenmann B. Localisation of neuroendocrine tumours of the upper gastrointestinal tract. Gut. 1994 Apr;35(4):471–475. doi: 10.1136/gut.35.4.471. [DOI] [PMC free article] [PubMed] [Google Scholar]
  72. de Kerviler E., Cadiot G., Lebtahi R., Faraggi M., Le Guludec D., Mignon M. Somatostatin receptor scintigraphy in forty-eight patients with the Zollinger-Ellison syndrome. GRESZE: Groupe d'Etude du Syndrome de Zollinger-Ellison. Eur J Nucl Med. 1994 Nov;21(11):1191–1197. doi: 10.1007/BF00182352. [DOI] [PubMed] [Google Scholar]

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