Zollinger-Ellison syndrome other imaging findings
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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]
- Somatostatin receptor scintigraphy (SRS) (octreotide scan)[2]
- Somatostatin receptor scintigraphy (SRS) using 111In-pentetreotide with single photon emission tomography (SPECT) scanning allows total body localization study simultaneously at one time, thus allowing detection of liver and distant metastases and it is more sensitive in both localizing the primary gastrinoma and identifying patients with liver metastases than conventional methods such as CT, MRI and US. [3]
Gallery
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Figure 1
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Figure 2
- 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]
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A
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B
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C
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D
- 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
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 4.0 4.1 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.
- ↑ Wosnitzer, Brian, and Ramesh Gadiraju. 'The Role Of Nuclear Imaging In Multiple Endocrine Neoplasia I (MEN1)'. Radiol. Case Rep. 5.4 (2010): n. pag. Web.