Abstract | BACKGROUND: [(111)In]- diethylenetriamine pentaacetic acid ( DTPA)-D-[Phe1]- octreotide ( OctreoScan, Mallinckrodt Medical, Petten, The Netherlands), combined with single photon emission computed tomography (SPECT), has limited possibilities to detect small abdominal endocrine tumors. This study explores the efficacy of OctreoScan and a newly developed handheld gamma detector probe (H-probe2) for the localization of neuroendocrine abdominal tumors. METHODS: Twenty-one patients with endocrine pancreatic or midgut carcinoid tumors were given 100-200 megabecquerels (MBq) [(111)In]- DTPA-D-[Phe1]- octreotide and underwent preoperative SPECT examination, after which time surgery was undertaken within 24-48 hours. Intraoperatively the radioactivity of tumors and normal tissues was measured with the H-probe2 connected to a portable personal computer. Resected intestinal specimens of ten patients with carcinoid tumors were examined by gamma camera ex vivo. Biopsies of all tumors subsequently were investigated in a wellcounter and by routine histopathology. RESULTS: Disregarding liver metastases, a total of 34 of 60 abdominal tumors were detected by SPECT; however, SPECT failed to visualize any tumor < 9 mm. The shielding of the manual probe allowed intraoperative examination despite the substantial radiation energy of (111)In. The H-probe2 detected 91% of the tumors investigated, and these included all those > 5 mm. In the wellcounter the H-probe2-detected tumors exhibited 4.7-157.7 times higher radionuclide uptake than the surrounding normal tissues. The gamma camera analysis detected 68% of tumors in the resected specimens. CONCLUSIONS: The intraoperative H-probe2 examination provided substantial improvement in the detection of small endocrine lesions accumulating [(111)In]- DTPA-D-[Phe1]- octreotide and all lesions with a size > 5 mm in greatest dimension could be identified.
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Authors | U Ohrvall, J E Westlin, S Nilsson, C Juhlin, J Rastad, H Lundqvist, G Akerström |
Journal | Cancer
(Cancer)
Vol. 80
Issue 12 Suppl
Pg. 2490-4
(Dec 15 1997)
ISSN: 0008-543X [Print] United States |
PMID | 9406700
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Indium Radioisotopes
- Receptors, Somatostatin
- Octreotide
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Carcinoid Tumor
(diagnostic imaging, pathology)
- Female
- Gamma Cameras
- Humans
- Indium Radioisotopes
- Intraoperative Period
- Male
- Middle Aged
- Octreotide
- Pancreatic Neoplasms
(diagnostic imaging, pathology)
- Receptors, Somatostatin
(analysis)
- Tomography, Emission-Computed, Single-Photon
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