A1 Refereed original research article in a scientific journal
Pancreatic imaging in MEN1-comparison of conventional and somatostatin receptor positron emission tomography/computed tomography imaging in real-life setting
Authors: Kostiainen Iiro, Majala Susanna, Schildt Jukka, Parviainen Helka, Kauhanen Saila, Seppänen Hanna, Miettinen Päivi J, Matikainen Niina, Ryhänen Eeva M, Schalin-Jäntti Camilla
Publisher: OXFORD UNIV PRESS
Publication year: 2023
Journal: European Journal of Endocrinology
Journal name in source: EUROPEAN JOURNAL OF ENDOCRINOLOGY
Journal acronym: EUR J ENDOCRINOL
Volume: 188
Issue: 5
First page : 421
Last page: 429
Number of pages: 9
ISSN: 0804-4643
DOI: https://doi.org/10.1093/ejendo/lvad035(external)
Web address : https://doi.org/10.1093/ejendo/lvad035(external)
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/179777018(external)
Objective
Pancreatic neuroendocrine tumors (panNETs) are the leading cause of death in patients with multiple endocrine neoplasia type 1 (MEN1). The role of somatostatin receptor positron emission tomography/computed tomography (SSTR PET/CT) in MEN1 has not been established. The aim was to assess pancreatic imaging in MEN1 in a real-life setting.
Design
Fifty-eight patients with MEN1 [median age 40 (range 16-72) years] underwent SSTR PET/CT imaging; either as a screening tool regardless of disease stage (n = 47) or to further characterize known panNETs (n = 11). SSTR PET/CT and matched conventional imaging were blindly analyzed. We assessed the findings and the impact of SSTR PET/CT during a median follow-up of 47 months.
Results
SSTR PET/CT detected three times as many panNETs as conventional imaging (P < .001). SSTR PET/CT altered the management of 27 patients (47%). Seven patients (12%) were referred for surgery, and five (9%) received systemic treatment. In 15/25 (60%) patients with no previous panNET (n = 22) or in remission after surgery (n = 3), SSTR PET/CT identified a panNET (n = 14) or recurrence (n = 1). In eight patients, SSTR PET/CT revealed a panNET not immediately visible on conventional imaging. During a median follow-up of 47 months, three became visible on conventional imaging, but none required intervention. When SSTR PET/CT was negative, no panNETs were identified on conventional imaging during 38 months of follow-up.
Conclusions
SSTR PET/CT demonstrates high accuracy in the detection of panNETs and alters the clinical management in nearly half of the MEN1-patients. SSTR PET/CT enables timely diagnosis and staging of MEN1-related panNETs.
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