Carcinoid syndrome other imaging findings: Difference between revisions
Jump to navigation
Jump to search
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
Other imaging studies for carcinoid tumor include [[somatostatin]] [[scintigraphy]] with | 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 Findings== | ||
Other imaging modalities for gastrointestinal carcinoids include the use of:<ref> Diagnostics: Biochemical Markers, Imaging, and Approach | 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> | . 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 | *[[Somatostatin]] [[scintigraphy]] with 111Indium[[Octreotide|-octreotide]] | ||
*[[Bone]] [[scintigraphy]] with 99mTc-methylene diphosphonate (99mTcMDP) | *[[Bone]] [[scintigraphy]] with 99mTc-[[methylene diphosphonate]] (99mTcMDP) | ||
*123 I-metaiodobenzylguanidine (MIBG) scintigraphy | *123 I-[[Metaiodobenzylguanidine|metaiodobenzylguanidine (MIBG]]) [[scintigraphy]] | ||
*[[Capsule endoscopy]] (CE) | *[[Capsule endoscopy]] (CE) | ||
*[[Enteroscopy]] | *[[Enteroscopy]] | ||
*[[Positron emission tomography]] (PET)/CT scan | *[[Positron emission tomography]] [[PET scan|(PET]])/[[CT scan]] | ||
*[[Angiography]] | *[[Angiography]] | ||
===Somatostatin Receptor Scintigraphy=== | ===Somatostatin Receptor Scintigraphy=== | ||
* It is the 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> | * It is the [[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 | *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 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 | *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]] o[[Imaging techniques|r imaging techniques]] requiring multiple sessions. | ||
*Overall sensitivity of the [[octreotide ]]scan is reported to be as high as 90%. | *Overall [[sensitivity]] of the [[octreotide ]]scan is reported to be as high as 90%. | ||
===Bone Scintigraphy=== | ===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. | *[[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. | *[[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]]. | ||
*However, 123I-MIBG appears to be about half as sensitive as 111In-[[octreotide]] [[scintigraphy]] in detecting tumors. | *However, [[123I-MIBG]] appears to be about half as [[Sensitivity|sensitive]] as 111In-[[octreotide]] [[scintigraphy]] in detecting [[Tumors|tumors.]] | ||
===Endoscopic Ultrasonography (EUS)=== | ===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. | *[[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=== | ===Positron Emission Tomography–Computed Tomography=== | ||
*PET-CT is now playing an ever-increasing role in both localizing disseminated cancer and monitoring the disease response to systemic 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> | *[[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 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-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. | *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. | ||
Revision as of 20:57, 21 April 2019
|
Carcinoid syndrome Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Carcinoid syndrome other imaging findings On the Web |
|
American Roentgen Ray Society Images of Carcinoid syndrome other imaging findings |
|
Risk calculators and risk factors for Carcinoid syndrome other imaging findings |
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.
- 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.[4]
- 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
- Identify the sources of vascular supply
- 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.
- ↑ 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.