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__NOTOC__ | __NOTOC__ | ||
{{Carcinoid syndrome}} | {{Carcinoid syndrome}} | ||
{{CMG}}{{AE}}{{PSD}} | |||
==Overview== | |||
Other [[imaging studies]] for [[carcinoid tumor]] include [[somatostatin]] [[scintigraphy]] with 111[[Indium]]-[[octreotide]], [[Scintigraphy|bone scintigraphy]] with 99mTc-[[methylene diphosphonate]] (99mTcMDP), 123 I[[Metaiodobenzylguanidine|-metaiodobenzylguanidine (MIBG]]) [[scintigraphy]], [[capsule endoscopy]] (CE), [[enteroscopy]], and [[angiography]]. | |||
==Other Imaging Findings== | |||
Other imaging modalities for [[gastrointestinal]] [[Carcinoid|carcinoids]] include the use of:<ref>Diagnostics: Biochemical Markers, Imaging, and Approach | |||
. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq#link/_49_toc Accessed on September 23, 2015</ref> | |||
*[[Somatostatin]] [[scintigraphy]] with 111Indium[[Octreotide|-octreotide]] | |||
*[[Bone]] [[scintigraphy]] with 99mTc-[[methylene diphosphonate]] (99mTcMDP) | |||
*123 I-[[Metaiodobenzylguanidine|metaiodobenzylguanidine (MIBG]]) [[scintigraphy]] | |||
*[[Capsule endoscopy]] (CE) | |||
*[[Enteroscopy]] | |||
*[[Positron emission tomography]] [[PET scan|(PET]])/[[CT scan]] | |||
*[[Angiography]] | |||
===Somatostatin Receptor Scintigraphy=== | |||
* It is the [[Gold standard (test)|gold standard]] in confirming the location of functioning [[neuroendocrine tumour]] [[tissue]].<ref name="SavelliLucignani2004">{{cite journal|last1=Savelli|first1=Giordano|last2=Lucignani|first2=Giovanni|last3=Seregni|first3=Ettore|last4=Marchian??|first4=Alfonso|last5=Serafini|first5=Gianluca|last6=Aliberti|first6=Gianluca|last7=Villano|first7=Carlo|last8=Maccauro|first8=Marco|last9=Bombardieri|first9=Emilio|title=Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours|journal=Nuclear Medicine Communications|volume=25|issue=5|year=2004|pages=445–449|issn=0143-3636|doi=10.1097/00006231-200405000-00004}}</ref> | |||
*There are five differen[[Somatostatin|t somatostatin]] [[receptor]] (SSTR) subtype, more than 70% of [[Neuroendocrine tumor|neuroendocrine tumors]] of both the [[gastrointestinal tract]] and [[pancreas]] express multiple subtypes predominantly 2 and 5. | |||
*[[Midgut]] [[Carcinoid Disease|carcinoids]] predominantly express [[Somatostatin receptor 2|somatostatin receptors from sub-group 2]] (sst2).<ref name="pmid12734860">{{cite journal |vauthors=Hashemi SH, Benjegård SA, Ahlman H, Wängberg B, Forssell-Aronsson E, Billig H, Nilsson O |title=111In-labelled octreotide binding by the somatostatin receptor subtype 2 in neuroendocrine tumours |journal=Br J Surg |volume=90 |issue=5 |pages=549–54 |date=May 2003 |pmid=12734860 |doi=10.1002/bjs.4069 |url=}}</ref> | |||
*The synthetic radiolabeled [[Somatostatin|SSTR]] analog 111In-DTP-d-Phe10-{[[octreotide]]} affords an important method, [[somatostatin receptor]] [[scintigraphy]] (SRS), to localize [[carcinoid tumors]], especially sst(2)-positive and sst(5)-positive [[tumors]],and small primary [[tumors]] and [[metastases]] are diagnosed more readily than with conventional [[imaging]] or imaging techniques requiring multiple sessions. | |||
*Overall [[sensitivity]] of the [[octreotide ]]scan is reported to be as high as 90%. | |||
===Bone Scintigraphy=== | |||
*[[Scintigraphy|Bone scintigraphy]] with 99mTcMDP is the primary imaging modality for identifying [[bone]] involvement in [[neuroendocrine tumors]] and detection rates are reported to be 90% or higher. | |||
*[[MIBG|123I-MIBG]] is concentrated by [[carcinoid tumors]] in as many as 70% of cases using the same mechanism as [[norepinephrine]] and is used successfully to visualize [[Carcinoid Disease|carcinoids]].<ref name="pmid12124478">{{cite journal |vauthors=Zuetenhorst JM, Hoefnageli CA, Boot H, Valdés Olmos RA, Taal BG |title=Evaluation of (111)In-pentetreotide, (131)I-MIBG and bone scintigraphy in the detection and clinical management of bone metastases in carcinoid disease |journal=Nucl Med Commun |volume=23 |issue=8 |pages=735–41 |date=August 2002 |pmid=12124478 |doi= |url=}}</ref> | |||
*However, [[MIBG|123I-MIBG]] appears to be about half as [[Sensitivity|sensitive]] as 111In-[[octreotide]] [[scintigraphy]] in detecting [[Tumors|tumors.]] | |||
===Endoscopic Ultrasonography (EUS)=== | |||
*[[Endoscopic]] [[ultrasonography]] (EUS) may be [[Sensitivity|a sensitive]] method for the detection of [[gastric]] and [[duodenal]] [[Carcinoid|carcinoids]] and may be superior to conventional ultrasound, particularly in the detection of small [[tumors]] (2 mm–3 mm) that are localized in the [[Bowel|bowel lumen]]. | |||
===Positron Emission Tomography–Computed Tomography=== | |||
*[[PET scan|PET]][[CT scan|-CT scan]] is now playing an ever-increasing role in both [[localizing]] disseminated [[Cancer (medicine)|cancer]] and monitoring the [[disease]] response to [[systemic]] [[Therapy|therapies]].<ref name="pmid15755858">{{cite journal |vauthors=Orlefors H, Sundin A, Garske U, Juhlin C, Oberg K, Skogseid B, Langstrom B, Bergstrom M, Eriksson B |title=Whole-body (11)C-5-hydroxytryptophan positron emission tomography as a universal imaging technique for neuroendocrine tumors: comparison with somatostatin receptor scintigraphy and computed tomography |journal=J. Clin. Endocrinol. Metab. |volume=90 |issue=6 |pages=3392–400 |date=June 2005 |pmid=15755858 |doi=10.1210/jc.2004-1938 |url=}}</ref> | |||
*[[Carcinoid]]-specific agents includes: 5[[Tryptophan|-hydroxy-l-tryptophan]] (5-HTP),64Cu-1,4,8,11-tetra-azacyclo-tetradecane-N,N′,N″, N‴-tera-acetic acid (TETA-OC) and 18F-dopa have been used. | |||
===Angiography=== | |||
[[MRI]] [[angiography]] has replaced [[angiography]] to a large extent. However, selective [[angiography]] may be useful to: | |||
*Demonstrate the degree of [[tumor]] [[vascularity]] | |||
*[[Angiography]] of the superior and inferior [[mesenteric artery]] has a reasonable sensitivity for the localization of the [[primary tumor]], [[lymph node]] and [[liver]] [[metastases]]. | |||
*Delineate the relationship of the [[tumor]] to adjacent major [[vascular]] structures | |||
*Provide information regarding [[vascular]] [[invasion]]. | |||
==References== | ==References== | ||
{{ | {{Reflist|2}} | ||
{{WS}} | |||
{{WH}} | {{WH}} | ||
[[Category: | [[Category:Gastroenterology]] | ||
[[Category: | [[Category:Endocrinology]] | ||
[[Category: | [[Category:Pulmonology]] | ||
[[Category:Hematology]] | [[Category:Hematology]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | [[Category:Oncology]] | ||
[[Category:Medicine]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
[[Category: | [[Category:Surgery]] | ||
Latest revision as of 19:58, 3 May 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
Overview
Other imaging studies for carcinoid tumor include somatostatin scintigraphy with 111Indium-octreotide, bone scintigraphy with 99mTc-methylene diphosphonate (99mTcMDP), 123 I-metaiodobenzylguanidine (MIBG) scintigraphy, capsule endoscopy (CE), enteroscopy, and angiography.
Other Imaging Findings
Other imaging modalities for gastrointestinal carcinoids include the use of:[1]
- Somatostatin scintigraphy with 111Indium-octreotide
- Bone scintigraphy with 99mTc-methylene diphosphonate (99mTcMDP)
- 123 I-metaiodobenzylguanidine (MIBG) scintigraphy
- Capsule endoscopy (CE)
- Enteroscopy
- Positron emission tomography (PET)/CT scan
- Angiography
Somatostatin Receptor Scintigraphy
- It is the gold standard in confirming the location of functioning neuroendocrine tumour tissue.[2]
- There are five different somatostatin receptor (SSTR) subtype, more than 70% of neuroendocrine tumors of both the gastrointestinal tract and pancreas express multiple subtypes predominantly 2 and 5.
- Midgut carcinoids predominantly express somatostatin receptors from sub-group 2 (sst2).[3]
- The synthetic radiolabeled SSTR analog 111In-DTP-d-Phe10-{octreotide} affords an important method, somatostatin receptor scintigraphy (SRS), to localize carcinoid tumors, especially sst(2)-positive and sst(5)-positive tumors,and small primary tumors and metastases are diagnosed more readily than with conventional imaging or imaging techniques requiring multiple sessions.
- Overall sensitivity of the octreotide scan is reported to be as high as 90%.
Bone Scintigraphy
- Bone scintigraphy with 99mTcMDP is the primary imaging modality for identifying bone involvement in neuroendocrine tumors and detection rates are reported to be 90% or higher.
- 123I-MIBG is concentrated by carcinoid tumors in as many as 70% of cases using the same mechanism as norepinephrine and is used successfully to visualize carcinoids.[4]
- However, 123I-MIBG appears to be about half as sensitive as 111In-octreotide scintigraphy in detecting tumors.
Endoscopic Ultrasonography (EUS)
- Endoscopic ultrasonography (EUS) may be a sensitive method for the detection of gastric and duodenal carcinoids and may be superior to conventional ultrasound, particularly in the detection of small tumors (2 mm–3 mm) that are localized in the bowel lumen.
Positron Emission Tomography–Computed Tomography
- PET-CT scan is now playing an ever-increasing role in both localizing disseminated cancer and monitoring the disease response to systemic therapies.[5]
- Carcinoid-specific agents includes: 5-hydroxy-l-tryptophan (5-HTP),64Cu-1,4,8,11-tetra-azacyclo-tetradecane-N,N′,N″, N‴-tera-acetic acid (TETA-OC) and 18F-dopa have been used.
Angiography
MRI angiography has replaced angiography to a large extent. However, selective angiography may be useful to:
- Demonstrate the degree of tumor vascularity
- Angiography of the superior and inferior mesenteric artery has a reasonable sensitivity for the localization of the primary tumor, lymph node and liver metastases.
- Delineate the relationship of the tumor to adjacent major vascular structures
- Provide information regarding vascular invasion.
References
- ↑ Diagnostics: Biochemical Markers, Imaging, and Approach . National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq#link/_49_toc Accessed on September 23, 2015
- ↑ Savelli, Giordano; Lucignani, Giovanni; Seregni, Ettore; Marchian??, Alfonso; Serafini, Gianluca; Aliberti, Gianluca; Villano, Carlo; Maccauro, Marco; Bombardieri, Emilio (2004). "Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours". Nuclear Medicine Communications. 25 (5): 445–449. doi:10.1097/00006231-200405000-00004. ISSN 0143-3636.
- ↑ Hashemi SH, Benjegård SA, Ahlman H, Wängberg B, Forssell-Aronsson E, Billig H, Nilsson O (May 2003). "111In-labelled octreotide binding by the somatostatin receptor subtype 2 in neuroendocrine tumours". Br J Surg. 90 (5): 549–54. doi:10.1002/bjs.4069. PMID 12734860.
- ↑ Zuetenhorst JM, Hoefnageli CA, Boot H, Valdés Olmos RA, Taal BG (August 2002). "Evaluation of (111)In-pentetreotide, (131)I-MIBG and bone scintigraphy in the detection and clinical management of bone metastases in carcinoid disease". Nucl Med Commun. 23 (8): 735–41. PMID 12124478.
- ↑ Orlefors H, Sundin A, Garske U, Juhlin C, Oberg K, Skogseid B, Langstrom B, Bergstrom M, Eriksson B (June 2005). "Whole-body (11)C-5-hydroxytryptophan positron emission tomography as a universal imaging technique for neuroendocrine tumors: comparison with somatostatin receptor scintigraphy and computed tomography". J. Clin. Endocrinol. Metab. 90 (6): 3392–400. doi:10.1210/jc.2004-1938. PMID 15755858.