Staffan Welin a Mats Stridsberg b Janet Cunningham a Dan Granberg a
Britt Skogseid a Kjell Öberg a Barbro Eriksson a Eva T. Janson a
Department of Medical Sciences, Unit of a Endocrine Oncology, b Clinical Chemistry, University Hospital,
Uppsala , Sweden
Conclusion: P-CgA was the first marker to indicate tumor recurrence in the majorityof radically operated midgut carcinoid patients. To avoid unnecessaryand costly examinations in asymptomatic patients,we suggest that follow-up should comprise measurementsof P-CgA twice a year and annual ultrasonographyuntil P-CgA is elevated or clinical symptoms occur, at which time all efforts should be made to identify recurrent tumorlesions in order to give the patient the best possible treatment which, if possible, should be surgical removal of the recurrence. NOTE: The importance of Chromogranin A as a neuroendicrine marker has been known and documented in the medical literature for over 20 years.
How to Diagnose and Monitor Carcinoid (neuroendocrine tumors):
Which Tests and How Often?
Compiled by Susan L. Anderson – September 9, 2002, Updated September 2005
Susan (a carcinoid patient) has compiled a summary of "Which tests and how often " from information provided by Drs. Anthony, Warner and
Woltering. After her summary there is additional information from each of these doctors based on their own experience and additional information for the physician .
Susan has provided information and support to the Carcinoid community since early 1997.
Tina Binderup, Ulrich Knigge, Annika Loft, Jann Mortensen, Andreas Pfeifer, Birgitte Federspiel, Carsten Palnaes Hansen, Liselotte Højgaard, and Andreas Kjaer
Authors’ Affiliations: Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen, Denmark; Cluster for Molecular Imaging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
J Nucl Med 2010; 51:704–712
Abstract
Functional techniques are playing a pivotal role in the imaging of cancer today. Our aim was to compare, on a head-to-head basis, 3 functional imaging techniques in patients with histologically verified neuroendocrine tumors: somatostatin receptor scintigraphy (SRS) with 111Indiethylenetriaminepentaacetic acidoctreotide, scintigraphy with 123I-metaiodobenzylguanidine (MIBG), and 18F-FDG PET. Methods: Ninety-six prospectively enrolled patients with neuroendocrine tumors underwent SRS, 123I-MIBG scintigraphy, and 18F-FDG PET on average within 40 d. The functional images were fused with low-dose CT scans for anatomic localization, and the imaging results were compared with the proliferation index as determined by Ki67. Results: The overall sensitivity of SRS, 123I-MIBG scintigraphy, and 18F-FDG PET was 89%, 52%, and 58%, respectively. Of the 11 SRS-negative patients, 7 were 18F-FDG PET-positive, of which 3 were also 123I-MIBG scintigraphy–positive, giving a combined overall sensitivity of 96%. SRS also exceeded 123I-MIBG scintigraphy and 18F-FDG PET based on the number of lesions detected (393, 185, and 225, respectively) and tumor subtypes. 123I-MIBG scintigraphy was superior to 18F-FDG PET for ileal neuroendocrine tumors, and 18F-FDG PET was superior to 123I-MIBG scintigraphy for pancreaticoduodenal neuroendocrine tumors. The sensitivity of 18F-FDG PET (92%) exceeded that of both SRS (69%) and 123I-MIBG scintigraphy (46%) for tumors with a proliferation index above 15%. Conclusion:The overall sensitivity of 123I-MIBG scintigraphy and 18F-FDG PET was low compared with SRS. However, for tumors with a high proliferation rate, 18F-FDG PET had the highest sensitivity. The results indicate that, although SRS should still be the routine method, 18F-FDG PET provides complementary diagnostic information and is of value for neuroendocrine tumor patients with negative SRS findings or a high proliferation index.
PMID: 20395333 [PubMed - as supplied by publisher]
Gallium-68 PET: a new frontier in receptor cancer imaging.
The recent introduction of PET imaging with gallium-68 has major bearings in current and future clinical practice. Its labelling with DOTA compounds has cleared the way for somatostatin receptor imaging with a viable PET agent, with all its inherent imaging advantages compared to single photon imaging. The pre-clinical and clinical applications of this technique has been successful in a variety of tumours, particularly Neuroendocrine Tumors (NETs) and its labelling with other ligands and molecules will improve the management of other tumours and the assessment of infection.
Last Modified:
Wednesday, 28-Apr-2010 14:15:20 EDT
