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Comparison of functional imaging and standard CT in evaluation of disease extent in patients with tumours showing neuroendocrine features
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Abstract
BACKGROUND: The diagnostic approach that should be used in disseminated neuroendocrine tumours (NET) remains a significant clinical problem. A novel approach has been the use of 111In Octreotide as functional imaging to find NETs. Therefore, the aim of this retrospective study is to report our comparison with direct CT as standard anatomical imaging.
MATERIAL AND METHODS: A total of 48 patients (aged 16-79 years; mean age 55, SD 14 years) were imaged using both techniques with final histological confirmation of NET. Histology was as follows: 26 carcinoids; 2 pheochromocytomas; 4 gastrinomas, 1 islet tumour; 2 paragangliomas, 1 modullary carcinoma of the thyroid, 8 undetermined NET and 4 other tumours with signs of neuro-ectodermal cancers (2 hepatocellular carcinomas (HCC), fibrolamellar HCC and fibrous tumour). All patients had 111In Octreotide and 30 had 123I mIBG scans followed by spiral CT with contrast enhancement. 26 patients had single functional scans and 22 had multiple, up to 6 scans. Extent of disease as number of lesions was compared between CT and octreotide.
RESULTS: CT was the best modality in 11 patients, in 6 it was as good as 111In Octreotide. mIBG was the best in 6 patients; in 3 patients mIBG was as good as octreotide study. In 22 patients 111In Octreotide was the most effective modality. In one patient there was no advantage with any of the tests. Comparison of the number of organs involved indicated that an octreotide study was much more effective than CT scanning (Wilcoxon matched pairs test, p < 0.001) and also the overall number of lesions detected using 111In Octreotide was greater than with CT (Wilcoxon Matched Pairs test p < 0.01).
CONCLUSION: Our results confirm the recommendation of the European NET group that functional imaging should be performed in patients with suspected NET.
Abstract
BACKGROUND: The diagnostic approach that should be used in disseminated neuroendocrine tumours (NET) remains a significant clinical problem. A novel approach has been the use of 111In Octreotide as functional imaging to find NETs. Therefore, the aim of this retrospective study is to report our comparison with direct CT as standard anatomical imaging.
MATERIAL AND METHODS: A total of 48 patients (aged 16-79 years; mean age 55, SD 14 years) were imaged using both techniques with final histological confirmation of NET. Histology was as follows: 26 carcinoids; 2 pheochromocytomas; 4 gastrinomas, 1 islet tumour; 2 paragangliomas, 1 modullary carcinoma of the thyroid, 8 undetermined NET and 4 other tumours with signs of neuro-ectodermal cancers (2 hepatocellular carcinomas (HCC), fibrolamellar HCC and fibrous tumour). All patients had 111In Octreotide and 30 had 123I mIBG scans followed by spiral CT with contrast enhancement. 26 patients had single functional scans and 22 had multiple, up to 6 scans. Extent of disease as number of lesions was compared between CT and octreotide.
RESULTS: CT was the best modality in 11 patients, in 6 it was as good as 111In Octreotide. mIBG was the best in 6 patients; in 3 patients mIBG was as good as octreotide study. In 22 patients 111In Octreotide was the most effective modality. In one patient there was no advantage with any of the tests. Comparison of the number of organs involved indicated that an octreotide study was much more effective than CT scanning (Wilcoxon matched pairs test, p < 0.001) and also the overall number of lesions detected using 111In Octreotide was greater than with CT (Wilcoxon Matched Pairs test p < 0.01).
CONCLUSION: Our results confirm the recommendation of the European NET group that functional imaging should be performed in patients with suspected NET.
Keywords
123I mIBG; 111In Octreotide; CT; neuroendocrine; tumours
Title
Comparison of functional imaging and standard CT in evaluation of disease extent in patients with tumours showing neuroendocrine features
Journal
Issue
Pages
27-34
Published online
2000-05-25
Page views
550
Article views/downloads
1155
Bibliographic record
Nucl. Med. Rev 2001;4(1):27-34.
Keywords
123I mIBG
111In Octreotide
CT
neuroendocrine
tumours
Authors
Jarosław B. Ćwikła
John R. Buscombe
Waldemar A. Mielcarek
Martyn E. Caplin
Anthony J. Watkinson
Andrew J.W. Hilson