Differentiation of Neuroendocrine Tumors from Other Pancreatic Lesions by Echo-Enhanced Power Doppler Sonography and Somatostatin Receptor Scintigraphy

Rickes, Steffen; Unkrodt, K; Ocran, K; Neye, Holger; Wermke, Wolfram

doi:10.1097/00006676-200301000-00013

Cited by 51 publications

(57 citation statements)

References 26 publications

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“…These values are notably higher than those reported for octreotide (OctreoScan; Covidien). In a study including 29 patients with suspected pancreatic NET, octreotide had a sensitivity of 54% and a specificity of 81% (16). In another study of 20 patients with the clinical suspicion of gastrinoma or insulinoma, octreotide was of high value in the detection of gastrinomas (sensitivity, 86%) but had a limited sensitivity (14%) in insulinomas (17).…”

Section: Discussionmentioning

confidence: 98%

The Role of ⁶⁸Ga-DOTATATE PET/CT in Suspected Neuroendocrine Tumors

Haug

Cindea-Drimus

Auernhammer³

et al. 2012

J Nucl Med

150

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In patients with suspected but yet not localized neuroendocrine tumors (NETs), early diagnosis or reliable exclusion is crucial for optimal individual prognosis and therapy. Despite recourse to several imaging modalities, the definite diagnosis of NET can be challenging. Therefore, we tested 68 Ga-DOTATATE PET/CT as a tool for improved diagnosis in a cohort of patients with suspected, nonlocalized NET. Methods: 68 Ga-DOTATATE PET/CT recordings were obtained in 104 consecutive patients meeting at least one of the following criteria: clinical suspicion of NET (n 5 70), elevated blood levels of tumor markers (n 5 49), and image-based suspicion of NET (n 5 53). The presence of NET was validated by histopathology (n 5 49) or clinical follow-up of 107 6 59 wk (n 5 55). Results: In 36 of 104 patients (35%), NET was histologically verified, most frequently located in the small bowel (10/36), pancreas (8/36), lung (5/36), and stomach (2/36). Twelve patients had tumors of nonneuroendocrine origin, and 7 patients had benign tumors. 68 Ga-DOTATATE PET/CT identified NET in 29 of the 36 cases and excluded the presence of a NET in 61 of the 68 non-NET patients, indicating a sensitivity of 81% and specificity of 90%. The PET/CT gave a false-positive result in 7 patients and a false-negative in another 7 patients, indicating positive and negative predictive values of 81% and 90%, respectively, and an accuracy of 87%. Chromogranin A levels were significantly higher in both PET-positive patients (1,841 vs. 342 ng/mL; P , 0.05) and patients with verified NET (2,214 vs. 524 ng/mL; P , 0.05). Conclusion: In patients with suspected NETs due to clinical symptoms, elevated levels of tumor markers, or indeterminate tumors suggestive of NET, 68 Ga-DOTATATE PET/CT is highly accurate, thus supporting its use in clinical routine diagnostics.

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Section: Discussionmentioning

confidence: 98%

The Role of ⁶⁸Ga-DOTATATE PET/CT in Suspected Neuroendocrine Tumors

Haug

Cindea-Drimus

Auernhammer³

et al. 2012

J Nucl Med

150

View full text Add to dashboard Cite

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“…In patients with a high degree of clinical suspicion but negative non-invasive imaging studies (US, CT and/or MRT), further diagnostic investigations may include contrast-enhanced US (sensitivity and specificity 94 and 96%, respectively) [61] or endoscopic ultrasound (EUS) with biopsies (sensitivity 82–86%) [62,63,64]. The sensitivity of CT and MR imaging is in the range of 75–79%, using comparable technical standards and equipment [65].…”

Section: Diagnostic Procedures Imagingmentioning

confidence: 99%

Well-Differentiated Pancreatic Nonfunctioning Tumors/Carcinoma

et al. 2006

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“…It consists of sulfur hexafluoride filled microbubbles which are surrounded by a shell composed of a phospholipidic monolayer. [12][13][14][15][16][17][18] The use of an echo enhancer increases the Doppler signal, which is generated by destroying the microbubbles. Echo enhanced ultrasound employs the so-called pulse inversion process, in which two ultrasonic waves that are 180˚out of phase with Abbreviations: CTSI, computed tomography severity index; NPV, negative predictive value; PPV, positive predictive value, Sn, sensitivity; Sp, specificity; USSI, ultrasound severity index.…”

mentioning

confidence: 99%

Echo-Enhanced Ultrasound – A New Valid Initial Imaging Approach for Severe Acute Pancreatitis

Rickes¹,

Uhle²,

Kahl³

et al. 2005

Ultraschall in Med

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Aim: This prospective study aimed to compare the accuracy of echo enhanced ultrasound with spiral computed tomography (CT) in assessing acute pancreatitis and to explore the correlation between ultrasound findings and clinical outcome. Methods: Thirty one patients (24 men and 7 women, median age 39 years, range 19-67 years) with acute pancreatitis were investigated by contrast enhanced CT and echo enhanced ultrasound within 72 hours after admission. Echo enhanced ultrasound (with intravenous injection of 2.4 ml SonoVue, pulse inversion technique, mechanical index 0.1 to 0.2, Siemens Elegra) was performed following conventional ultrasound. Balthazar's grading system was used to measure CT and ultrasound severity indices (CTSI and USSI). Correlations between CTSI and USSI and between USSI and clinical parameters were tested by Spearman's rank correlation coefficient. Results: A strong correlation was demonstrated between CTSI and USSI (r = 0.807, p,0.01). Ultrasound correlated with the following: the Ranson score (r = 0.401, p,0.05), C-reactive protein levels 48 hours after admission (r = 0.536, p,0.01), duration of hospitalisation (r = 0.422, p,0.05), and clinical outcome regarding morbidity, including local and systemic complications (r = 0.363, p,0.05). Based on CT findings as the gold standard, sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound for detecting severe acute pancreatitis based on imaging criteria (Balthazar score D or E and/or presence of hypoperfusion compatible with necrosis and/or SI>3) were, respectively, 82% (95% CI 61 to 93), 89% (95% CI 57 to 98), 95% (95% CI 75 to 99), and 67% (95% CI 39 to 86). Conclusion: Echo enhanced ultrasound produces excellent results in the staging of acute pancreatitis severity. The procedure is cheaper and has fewer contraindications than CT. Further multicentre studies need to be performed before including the method in the diagnostic algorithm of patients with acute pancreatitis.

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Differentiation of Neuroendocrine Tumors from Other Pancreatic Lesions by Echo-Enhanced Power Doppler Sonography and Somatostatin Receptor Scintigraphy

Abstract: Echo-enhanced power Doppler sonography has high sensitivity and high specificity for the differentiation of neuroendocrine lesions from other pancreatic tumors. However, histologic evidence is the standard of reference for the differential diagnosis of pancreatic tumors.

Cited by 51 publications

References 26 publications

The Role of ⁶⁸Ga-DOTATATE PET/CT in Suspected Neuroendocrine Tumors

The Role of ⁶⁸Ga-DOTATATE PET/CT in Suspected Neuroendocrine Tumors

Well-Differentiated Pancreatic Nonfunctioning Tumors/Carcinoma

Echo-Enhanced Ultrasound – A New Valid Initial Imaging Approach for Severe Acute Pancreatitis

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Differentiation of Neuroendocrine Tumors from Other Pancreatic Lesions by Echo-Enhanced Power Doppler Sonography and Somatostatin Receptor Scintigraphy

Abstract: Echo-enhanced power Doppler sonography has high sensitivity and high specificity for the differentiation of neuroendocrine lesions from other pancreatic tumors. However, histologic evidence is the standard of reference for the differential diagnosis of pancreatic tumors.

Cited by 51 publications

References 26 publications

The Role of 68Ga-DOTATATE PET/CT in Suspected Neuroendocrine Tumors

The Role of 68Ga-DOTATATE PET/CT in Suspected Neuroendocrine Tumors

Well-Differentiated Pancreatic Nonfunctioning Tumors/Carcinoma

Echo-Enhanced Ultrasound – A New Valid Initial Imaging Approach for Severe Acute Pancreatitis

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The Role of ⁶⁸Ga-DOTATATE PET/CT in Suspected Neuroendocrine Tumors

The Role of ⁶⁸Ga-DOTATATE PET/CT in Suspected Neuroendocrine Tumors