Vasoactive intestinal peptide-receptor imaging for the localization of intestinal adenocarcinomas and endocrine tumors.

Abstract

BACKGROUND:

Intestinal adenocarcinomas and various endocrine tumors express large numbers of high-affinity receptors for vasoactive intestinal peptide (VIP). We have evaluated the usefulness of scanning with VIP labeled with iodine-123 for tumor localization in patients with gastrointestinal tumors.

METHODS:

Radioiodinated VIP was purified by high-pressure liquid chromatography and administered as a single intravenous bolus injection (300 pmol [1 microgram]). Scanning with radiolabeled VIP was compared with computed tomography and scanning with somatostatin analogues in 79 patients with colorectal cancer, pancreatic carcinoma, gastric cancer, carcinoid tumor, or insulinoma.

RESULTS:

Visualization of gastrointestinal tumors and metastases was obtained with radiolabeled VIP. Binding of the labeled peptide by primary tumors and metastases was visible shortly after the injection and was still demonstrable at 24 hours. In patients with colorectal adenocarcinomas, primary or recurrent tumors were visualized in 10 of 10, liver metastases in 15 of 18, lung metastases in 2 of 3, and lymph-node metastases in 4 of 4. Primary pancreatic adenocarcinomas were visualized by imaging in 10 of 12 patients, and liver metastases were seen in 7 of 7. Primary or recurrent gastric adenocarcinomas were visualized in 5 of 5 patients, and liver metastases were seen in 2 of 2 patients. VIP scans were positive in 9 of 10 patients with carcinoid tumors and in 4 of 4 patients with insulinomas. Some tumors with positive VIP scans were also visualized with somatostatin analogues (4 of 17 colorectal adenocarcinomas, 8 of 9 carcinoids, and 2 of 2 insulinomas). In vitro binding studies confirmed the presence of VIP receptors on gastrointestinal tumors.

CONCLUSIONS:

Scanning with radiolabeled VIP can visualize intestinal tumors and metastases that express receptors for VIP.

• Authors: I Virgolini, M Raderer, A Kurtaran, P Angelberger, S Banyai, Q Yang, S Li, M Banyai, J Pidlich, B Niederle, W Scheithauer, P Valent
• Journal: The New England journal of medicine (N Engl J Med) Vol. 331 Issue 17 Pg. 1116-21 (Oct 27 1994) ISSN: 0028-4793 [Print] United States
• PMID: 7935635 (Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Iodine Radioisotopes
• Receptors, Somatostatin
• Receptors, Vasoactive Intestinal Peptide
• Vasoactive Intestinal Peptide
• Octreotide

Topics

• Adenocarcinoma (diagnostic imaging, metabolism)
• Carcinoid Tumor (diagnostic imaging, metabolism)
• Colorectal Neoplasms (diagnostic imaging, metabolism)
• Female
• Gastrointestinal Neoplasms (diagnostic imaging, metabolism)
• Humans
• Insulinoma (diagnostic imaging, metabolism)
• Iodine Radioisotopes
• Male
• Octreotide
• Pancreatic Neoplasms (diagnostic imaging, metabolism)
• Radionuclide Imaging
• Receptors, Somatostatin (analysis)
• Receptors, Vasoactive Intestinal Peptide (analysis)
• Stomach Neoplasms (diagnostic imaging, metabolism)
• Vasoactive Intestinal Peptide