Carcinoid syndrome other imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Other Imaging Findings

For localization of both primary lesions and metastasis, the initial imaging method is Octreoscan, where <math>{}^{111}</math>Indium labelled somatostatin analogues (octreotide) are used in scintigraphy for detecting tumors expressing somatostatin receptors. Median detection rates with octreoscan are about 89%, in contrast to other imaging techniques such as CT scans and MRI with detection rates of about 80%. Usually on CT scan, one will note a spider-like/crab like change in the messentery due to the fibrosis from the release of serotonin. PET scans, which evaluate for increased metabolism of glucose, may also aid in localizing the carcinoid lesion or evaluating for metastases.

Localization

Tumour localization may be extremely difficult. Barium swallow and follow-up examination of the intestine may occasionally show the tumour. Capsule video endoscopy has recently been used to localized the tumour. Often laparotomy is the definitive way to localize the tumour.

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