Zollinger-Ellison syndrome other imaging findings: Difference between revisions

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==Gallery==
==Gallery==


<gallery widths="300px" class="center">
[[File:ZES_SRS_1.jpg|thumb|none|350px| Figure 1, In-111 pentetreotide octreotide scan. Yang RH, Chu YK, CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0. <ref name="pmid27408649">{{cite journal| author=Yang RH, Chu YK| title=Zollinger-Ellison syndrome: Revelation of the gastrinoma triangle. | journal=Radiol Case Rep | year= 2015 | volume= 10 | issue= 1 | pages= 827 | pmid=27408649 | doi=10.2484/rcr.v10i1.827 | pmc=4921170 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27408649  }} </ref>]]
ZES_SRS_1.jpg| Figure 1
[[File:ZES_SRS_2.jpg|thumb|none|350px| Figure 2, Pentetreotide imaging plus abdomen scintigrams. Yang RH, Chu YK, CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0. <ref name="pmid27408649">{{cite journal| author=Yang RH, Chu YK| title=Zollinger-Ellison syndrome: Revelation of the gastrinoma triangle. | journal=Radiol Case Rep | year= 2015 | volume= 10 | issue= 1 | pages= 827 | pmid=27408649 | doi=10.2484/rcr.v10i1.827 | pmc=4921170 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27408649  }} </ref>]]
ZES_SRS_2.jpg| Figure 2
 
</gallery>


*'''Figure 1:''' An In-111 pentetreotide octreotide scan showed an avid focus at the epigastrium (open arrow), besides physiologic uptake in the kidneys and the spleen. <ref name="pmid27408649">{{cite journal| author=Yang RH, Chu YK| title=Zollinger-Ellison syndrome: Revelation of the gastrinoma triangle. | journal=Radiol Case Rep | year= 2015 | volume= 10 | issue= 1 | pages= 827 | pmid=27408649 | doi=10.2484/rcr.v10i1.827 | pmc=4921170 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27408649  }} </ref>
*'''Figure 1:''' An In-111 pentetreotide octreotide scan showed an avid focus at the epigastrium (open arrow), besides physiologic uptake in the kidneys and the spleen. <ref name="pmid27408649">{{cite journal| author=Yang RH, Chu YK| title=Zollinger-Ellison syndrome: Revelation of the gastrinoma triangle. | journal=Radiol Case Rep | year= 2015 | volume= 10 | issue= 1 | pages= 827 | pmid=27408649 | doi=10.2484/rcr.v10i1.827 | pmc=4921170 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27408649  }} </ref>
*'''Figure 2:''' Pentetreotide imaging plus abdomen scintigrams. The patient was asked to drink a mouthful of water with Tc-99m pertechnetate added. Dual-isotope planar images were acquired simultaneously, centering on the In-111 photopeaks and on the Tc-99m photopeak. <ref name="pmid27408649">{{cite journal| author=Yang RH, Chu YK| title=Zollinger-Ellison syndrome: Revelation of the gastrinoma triangle. | journal=Radiol Case Rep | year= 2015 | volume= 10 | issue= 1 | pages= 827 | pmid=27408649 | doi=10.2484/rcr.v10i1.827 | pmc=4921170 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27408649  }} </ref>
*'''Figure 2:''' Pentetreotide imaging plus abdomen scintigrams. The patient was asked to drink a mouthful of water with Tc-99m pertechnetate added. Dual-isotope planar images were acquired simultaneously, centering on the In-111 photopeaks and on the Tc-99m photopeak. <ref name="pmid27408649">{{cite journal| author=Yang RH, Chu YK| title=Zollinger-Ellison syndrome: Revelation of the gastrinoma triangle. | journal=Radiol Case Rep | year= 2015 | volume= 10 | issue= 1 | pages= 827 | pmid=27408649 | doi=10.2484/rcr.v10i1.827 | pmc=4921170 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27408649  }} </ref>


<gallery widths="200px" class="center">
SRS1.jpg| A
SRS2.jpg| B
SRS3.jpg| C
SRS4.jpg| D
</gallery>


*'''Figures A-D:''' A 37-year-old male with MEN 1. The patient was injected with 6.4 mCi In-111 octreotide, and images were acquired in the anterior and posterior projections at 4 hours (A) and 24 hours (B). SPECT images were also obtained at 24 hours (C, axial, and D, coronal). Findings are consistent with metastatic somatostatin-receptor-positive malignancy involving the lymph nodes either in the peripancreatic or porta hepatis region.<ref name="pmid27408649">{{cite journal |vauthors=Yang RH, Chu YK |title=Zollinger-Ellison syndrome: Revelation of the gastrinoma triangle |journal=Radiol Case Rep |volume=10 |issue=1 |pages=827 |year=2015 |pmid=27408649 |pmc=4921170 |doi=10.2484/rcr.v10i1.827 |url=}}</ref>
[[File:SRS1.jpg|thumb|none|350px|A, In-111 octreotide scan at 4hrs, Wosnitzer B, Gadiraju R, CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0, <ref name="pmid27307880">{{cite journal |vauthors=Wosnitzer B, Gadiraju R |title=The role of nuclear imaging in multiple endocrine neoplasia 1 (MEN 1) |journal=Radiol Case Rep |volume=5 |issue=4 |pages=452 |year=2010 |pmid=27307880 |pmc=4901017 |doi=10.2484/rcr.v5i4.452 |url=}}</ref>]]
[[File:SRS2.jpg|thumb|none|350px|B, In-111 octreotide scan at 24hrs , Wosnitzer B, Gadiraju R, CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0, <ref name="pmid27307880">{{cite journal |vauthors=Wosnitzer B, Gadiraju R |title=The role of nuclear imaging in multiple endocrine neoplasia 1 (MEN 1) |journal=Radiol Case Rep |volume=5 |issue=4 |pages=452 |year=2010 |pmid=27307880 |pmc=4901017 |doi=10.2484/rcr.v5i4.452 |url=}}</ref>]]
[[File:SRS3.jpg|thumb|none|350px|C, SPECT images at 24 hrs, Wosnitzer B, Gadiraju R, CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0, <ref name="pmid27307880">{{cite journal |vauthors=Wosnitzer B, Gadiraju R |title=The role of nuclear imaging in multiple endocrine neoplasia 1 (MEN 1) |journal=Radiol Case Rep |volume=5 |issue=4 |pages=452 |year=2010 |pmid=27307880 |pmc=4901017 |doi=10.2484/rcr.v5i4.452 |url=}}</ref>]]
[[File:SRS4.jpg|thumb|none|350px|D, SPECT images at 24 hrs, Wosnitzer B, Gadiraju R, CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0, <ref name="pmid27307880">{{cite journal |vauthors=Wosnitzer B, Gadiraju R |title=The role of nuclear imaging in multiple endocrine neoplasia 1 (MEN 1) |journal=Radiol Case Rep |volume=5 |issue=4 |pages=452 |year=2010 |pmid=27307880 |pmc=4901017 |doi=10.2484/rcr.v5i4.452 |url=}}</ref>]]
 
 
*'''Figures A-D:''' A 37-year-old male with MEN 1. The patient was injected with 6.4 mCi In-111 octreotide, and images were acquired in the anterior and posterior projections at 4 hours (A) and 24 hours (B). SPECT images were also obtained at 24 hours (C, axial, and D, coronal). Findings are consistent with metastatic somatostatin-receptor-positive malignancy involving the lymph nodes either in the peripancreatic or porta hepatis region.<ref name="pmid27307880">{{cite journal |vauthors=Wosnitzer B, Gadiraju R |title=The role of nuclear imaging in multiple endocrine neoplasia 1 (MEN 1) |journal=Radiol Case Rep |volume=5 |issue=4 |pages=452 |year=2010 |pmid=27307880 |pmc=4901017 |doi=10.2484/rcr.v5i4.452 |url=}}</ref>


==References==
==References==

Revision as of 23:19, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2] Aravind Reddy Kothagadi M.B.B.S[3]

Overview

Endoscopic ultrasound and somatostatin receptor scintigraphy (SRS) (octreotide scan) may be helpful in the diagnosis of Zollinger-Ellison syndrome caused by gastrinoma.

Other Imaging Findings

Other imaging studies that may be helpful in the diagnosis of Zollinger-Ellison syndrome include: [1]

Gallery

Figure 1, In-111 pentetreotide octreotide scan. Yang RH, Chu YK, CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0. [4]
Figure 2, Pentetreotide imaging plus abdomen scintigrams. Yang RH, Chu YK, CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0. [4]


  • Figure 1: An In-111 pentetreotide octreotide scan showed an avid focus at the epigastrium (open arrow), besides physiologic uptake in the kidneys and the spleen. [4]
  • Figure 2: Pentetreotide imaging plus abdomen scintigrams. The patient was asked to drink a mouthful of water with Tc-99m pertechnetate added. Dual-isotope planar images were acquired simultaneously, centering on the In-111 photopeaks and on the Tc-99m photopeak. [4]


A, In-111 octreotide scan at 4hrs, Wosnitzer B, Gadiraju R, CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0, [5]
B, In-111 octreotide scan at 24hrs , Wosnitzer B, Gadiraju R, CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0, [5]
C, SPECT images at 24 hrs, Wosnitzer B, Gadiraju R, CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0, [5]
D, SPECT images at 24 hrs, Wosnitzer B, Gadiraju R, CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0, [5]


  • Figures A-D: A 37-year-old male with MEN 1. The patient was injected with 6.4 mCi In-111 octreotide, and images were acquired in the anterior and posterior projections at 4 hours (A) and 24 hours (B). SPECT images were also obtained at 24 hours (C, axial, and D, coronal). Findings are consistent with metastatic somatostatin-receptor-positive malignancy involving the lymph nodes either in the peripancreatic or porta hepatis region.[5]

References

  1. Tang, Shou-jiang; Wu, Ruonan; Bhaijee, Feriyl (2014). "Zollinger–Ellison Syndrome". Video Journal and Encyclopedia of GI Endoscopy. 1 (3–4): 666–668. doi:10.1016/j.vjgien.2013.06.005. ISSN 2212-0971.
  2. Cadiot G, Bonnaud G, Lebtahi R, Sarda L, Ruszniewski P, Le Guludec D; et al. (1997). "Usefulness of somatostatin receptor scintigraphy in the management of patients with Zollinger-Ellison syndrome. Groupe de Recherche et d'Etude du Syndrome de Zollinger-Ellison (GRESZE)". Gut. 41 (1): 107–14. PMC 1027237. PMID 9274481.
  3. Gibril F, Reynolds JC, Doppman JL, Chen CC, Venzon DJ, Termanini B; et al. (1996). "Somatostatin receptor scintigraphy: its sensitivity compared with that of other imaging methods in detecting primary and metastatic gastrinomas. A prospective study". Ann Intern Med. 125 (1): 26–34. PMID 8644985.
  4. 4.0 4.1 4.2 4.3 Yang RH, Chu YK (2015). "Zollinger-Ellison syndrome: Revelation of the gastrinoma triangle". Radiol Case Rep. 10 (1): 827. doi:10.2484/rcr.v10i1.827. PMC 4921170. PMID 27408649.
  5. 5.0 5.1 5.2 5.3 5.4 Wosnitzer B, Gadiraju R (2010). "The role of nuclear imaging in multiple endocrine neoplasia 1 (MEN 1)". Radiol Case Rep. 5 (4): 452. doi:10.2484/rcr.v5i4.452. PMC 4901017. PMID 27307880.

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