Nuclear medicine in the detection and management of pancreatic islet-cell tumours.

Abstract

Over the last decade somatostatin receptor scintigraphy using various derivatives of long-acting somatostatin analogues has gained its place in the management of pancreatic islet-cell tumours. Scintigraphy is based on the high-affinity binding of such somatostatin analogues to receptors over-expressed by these tumour types. Following the introduction of (111)In-DTPA-D-Phe(1)-octreotide, clinical studies with radiolabelled DOTA-Tyr(3)-octreotide and DOTA-Tyr(3)-octreotate derivatives have shown considerable improvement of imaging results with increased tumour uptake. One of the newer developments, (68)Ga-labelled DOTA-Tyr(3)-octreotide, has shown promising results in patients with pancreatic islet-cell tumours, based on the high-affinity binding to the somatostatin receptor subtype 2 in combination with positron emission tomography (PET) technology. Other peptides--such as ligands for the gastrin/CCK2 receptors or vasoactive intestinal peptide (VIP)--have also been studied for imaging pancreatic cell tumours. Whereas small-sized gastrinoma, somatostatinoma, glucagonoma, carcinoid and VIPoma are frequently detected by somatostatin receptor scintigraphy, insulinoma may escape detection due to reduced receptor expression. Following peptide receptor scintigraphy, a change in patient management is reported in up to 30% of patients. When labelled with (90)Y or (177)Lu, some somatostatin analogues have been applied to patients in advanced stages of the disease. Despite positive response data in 50% of patients, long-term results and survival rates are lacking.

• Authors: Irene Virgolini, Tatjana Traub-Weidinger, Clemens Decristoforo
• Journal: Best practice & research. Clinical endocrinology & metabolism (Best Pract Res Clin Endocrinol Metab) Vol. 19 Issue 2 Pg. 213-27 (Jun 2005) ISSN: 1521-690X [Print] Netherlands
• PMID: 15763696 (Publication Type: Journal Article, Review)

Chemical References

• Radiopharmaceuticals
• Somatostatin

Topics

• Adenoma, Islet Cell (diagnostic imaging, radiotherapy)
• Female
• Humans
• Islets of Langerhans (diagnostic imaging)
• Male
• Nuclear Medicine (methods)
• Pancreatic Neoplasms (diagnostic imaging, radiotherapy)
• Radionuclide Imaging
• Radiopharmaceuticals (therapeutic use)
• Somatostatin (analogs & derivatives)