Multiple endocrine neoplasia type 1 other imaging findings: Difference between revisions
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{{CMG}}; {{AE}} {{Ammu}} | {{CMG}}; {{AE}} {{Ammu}} | ||
==Overview== | ==Overview== | ||
Other imaging studies for multiple endocrine neoplasia type 1 include fluoro-di-glucose-[[PET]]/[[CT]], | Other imaging studies for multiple endocrine neoplasia type 1 include fluoro-di-glucose-[[PET]]/[[CT]], venous sampling, [[angiography]] and endovascular procedures, such as trans-arterial chemo-[[embolization]] (TACE). | ||
===Nuclear Medicine<ref name=Radiopaedia012015>{{cite web | title = Radiopedia2015 Gastrointestinal neuroendocrine tumours [Dr Dalia Ibrahim and Dr Jan Smith]| url = http://radiopaedia.org/articles/gastrointestinal-neuroendocrine-tumours-3 }}</ref>=== | ===Nuclear Medicine<ref name=Radiopaedia012015>{{cite web | title = Radiopedia2015 Gastrointestinal neuroendocrine tumours [Dr Dalia Ibrahim and Dr Jan Smith]| url = http://radiopaedia.org/articles/gastrointestinal-neuroendocrine-tumours-3 }}</ref>=== | ||
* Common radiopharmaceutical agent is 111-indium-pentetreotide, which is a [[ligand]] for [[somatostatin]] receptor on the [[cell membrane]] of many [[neuroendocrine tumor]]s. Multiple [[tumor]] sites and [[metastasis]] can be identified using a gamma-camera which detect the emitted [[radiation]]. | * Common radiopharmaceutical agent is 111-indium-pentetreotide, which is a [[ligand]] for [[somatostatin]] receptor on the [[cell membrane]] of many [[neuroendocrine tumor]]s. Multiple [[tumor]] sites and [[metastasis]] can be identified using a gamma-camera which detect the emitted [[radiation]]. | ||
* Can be used in combination with cross-sectional imaging modalities to aid staging e.g. [[SPECT]] or [[PET]]-[[CT]] or [[PET]]-[[MRI]] | * Can be used in combination with cross-sectional imaging modalities to aid staging e.g. [[SPECT]] or [[PET]]-[[CT]] or [[PET]]-[[MRI]] | ||
* Can be used to predict response to nuclear medicine based therapies, and, in some cases, to assess response to | * Can be used to predict response to nuclear medicine based therapies, and, in some cases, to assess response to treatment | ||
* Care should be taken with interpretation of images as [[drug]]s can interfere with | * Care should be taken with interpretation of images as [[drug]]s can interfere with somatostain receptor expression, e.g. [[interferon]]. | ||
* [[Neuroendocrine tumor]]s can differentiate into [[tumor]]s that do not express [[somatostatin receptor]]s can become ‘image negative’ making reoccurrence or [[metastases]] more challenging to detect. Other radiopharmaceuticals are also used, based on certain physiological characteristics e.g. [[cell surface receptor]]s or uptake of molecules. | * [[Neuroendocrine tumor]]s can differentiate into [[tumor]]s that do not express [[somatostatin receptor]]s can become ‘image negative’ making reoccurrence or [[metastases]] more challenging to detect. Other radiopharmaceuticals are also used, based on certain physiological characteristics e.g. [[cell surface receptor]]s or uptake of molecules. | ||
* Gallium-68 labelled somatostatin analogues ([[PET]]/[[CT]]) is thought to be more sensitive in detecting [[neuroendocrine tumor]]s except pulmonary and hepatic [[metastases]]. For aggressive, rapidly growing [[tumor]]s (i.e. high metabolism) fluoro-di-glucose-[[PET]]/[[CT]] can be used (FDG-PET) | * Gallium-68 labelled somatostatin analogues ([[PET]]/[[CT]]) is thought to be more sensitive in detecting [[neuroendocrine tumor]]s except pulmonary and hepatic [[metastases]]. For aggressive, rapidly growing [[tumor]]s (i.e. high metabolism) fluoro-di-glucose-[[PET]]/[[CT]] can be used (FDG-PET) | ||
* F18 DOPA and C11 Hydroxy[[tryptophan]] may be used in future but are not routinely available. | * F18 DOPA and C11 Hydroxy[[tryptophan]] may be used in future but are not routinely available. | ||
===Invasive Imaging Techniques=== | ===Invasive Imaging Techniques=== | ||
* | * Venous sampling can be used in small functional [[neuroendocrine tumor]]s where cross sec-tional imaging is equivocal. | ||
* Multiple endocrine neoplasia type 1 can present with multiple lesions. Functional [[neuroendocrine tumor]]s can be identified from these, using [[calcium]] stimulation with | * Multiple endocrine neoplasia type 1 can present with multiple lesions. Functional [[neuroendocrine tumor]]s can be identified from these, using [[calcium]] stimulation with venous sampling. | ||
* [[Angiography]] and | * [[Angiography]] and endovascular procedures, such as trans-arterial chemo-[[embolization]] (TACE), can be used to treat hepatic [[metastases]]. | ||
==Reference== | ==Reference== | ||
{{Reflist}} | {{Reflist}} | ||
[[Category:Hereditary cancers]] | [[Category:Hereditary cancers]] | ||
Revision as of 04:50, 14 September 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Overview
Other imaging studies for multiple endocrine neoplasia type 1 include fluoro-di-glucose-PET/CT, venous sampling, angiography and endovascular procedures, such as trans-arterial chemo-embolization (TACE).
Nuclear Medicine[1]
- Common radiopharmaceutical agent is 111-indium-pentetreotide, which is a ligand for somatostatin receptor on the cell membrane of many neuroendocrine tumors. Multiple tumor sites and metastasis can be identified using a gamma-camera which detect the emitted radiation.
- Can be used in combination with cross-sectional imaging modalities to aid staging e.g. SPECT or PET-CT or PET-MRI
- Can be used to predict response to nuclear medicine based therapies, and, in some cases, to assess response to treatment
- Care should be taken with interpretation of images as drugs can interfere with somatostain receptor expression, e.g. interferon.
- Neuroendocrine tumors can differentiate into tumors that do not express somatostatin receptors can become ‘image negative’ making reoccurrence or metastases more challenging to detect. Other radiopharmaceuticals are also used, based on certain physiological characteristics e.g. cell surface receptors or uptake of molecules.
- Gallium-68 labelled somatostatin analogues (PET/CT) is thought to be more sensitive in detecting neuroendocrine tumors except pulmonary and hepatic metastases. For aggressive, rapidly growing tumors (i.e. high metabolism) fluoro-di-glucose-PET/CT can be used (FDG-PET)
- F18 DOPA and C11 Hydroxytryptophan may be used in future but are not routinely available.
Invasive Imaging Techniques
- Venous sampling can be used in small functional neuroendocrine tumors where cross sec-tional imaging is equivocal.
- Multiple endocrine neoplasia type 1 can present with multiple lesions. Functional neuroendocrine tumors can be identified from these, using calcium stimulation with venous sampling.
- Angiography and endovascular procedures, such as trans-arterial chemo-embolization (TACE), can be used to treat hepatic metastases.