Tags

Type your tag names separated by a space and hit enter

EUS is superior for detection of pancreatic lesions compared with standard imaging in patients with multiple endocrine neoplasia type 1.
Gastrointest Endosc. 2015 Jan; 81(1):159-167.e2.GE

Abstract

BACKGROUND

In multiple endocrine neoplasia type 1 (MEN1), pancreatic neuroendocrine tumors (pNETs) are the leading MEN1-related cause of death.

OBJECTIVE

To evaluate EUS and (11)C-5-hydroxytryptophan positron emission tomography ((11)C-5-HTP PET), compared with the recommended screening techniques in MEN1 patients for early detection of pNETs.

DESIGN

Cross-sectional study.

SETTING

Tertiary-care university medical center.

PATIENTS

This study involved 41 patients with a proven MEN1 mutation or with one MEN1 manifestation and a mutation carrier as a first-degree family member, with recent screening by abdominal CT or magnetic resonance imaging (MRI) and somatostatin receptor scintigraphy (SRS).

INTERVENTIONS

EUS by using a linear Pentax echoendoscope and Hitachi EUB-525 and (11)C-5-HTP PET.

MAIN OUTCOME MEASUREMENTS

Patient-based and lesion-based positivity for pNET was calculated for all imaging techniques. The McNemar test was used to compare the yield of the 4 imaging techniques.

RESULTS

In 35 of 41 patients, 107 pancreatic lesions were detected in total. EUS detected 101 pancreatic lesions in 34 patients, (11)C-5-HTP PET detected 35 lesions in 19 patients, and CT/MRI + SRS detected 32 lesions in 18 patients (P < .001). (11)C-5-HTP PET performed similarly to CT/MRI + SRS and better compared with SRS only (13 lesions in 12 patients), both at a patient-based and lesion-based level (P < .05).

LIMITATIONS

Single-center study.

CONCLUSION

EUS is superior to CT/MRI + SRS for pancreatic lesion detection in patients with MEN1. In this setting, (11)C-5-HTP PET is not useful. We recommend EUS as the first-choice pancreas imaging technique in patients with MEN1. (

CLINICAL TRIAL REGISTRATION NUMBER

NTR1668.).

Authors+Show Affiliations

Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.Department of Gastroenterology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.Department of Nuclear Medicine and Molecular Imaging, Martini Hospital Groningen, Groningen, The Netherlands.Department of Endocrinology, University Medical Center Utrecht, Utrecht, The Netherlands.Department of Medicine, Division of Endocrinology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.Department of Endocrinology, University Erasmus Medical Center, Rotterdam, The Netherlands.Department of Endocrinology, University Erasmus Medical Center, Rotterdam, The Netherlands.Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25527055

Citation

van Asselt, Sophie J., et al. "EUS Is Superior for Detection of Pancreatic Lesions Compared With Standard Imaging in Patients With Multiple Endocrine Neoplasia Type 1." Gastrointestinal Endoscopy, vol. 81, no. 1, 2015, pp. 159-167.e2.
van Asselt SJ, Brouwers AH, van Dullemen HM, et al. EUS is superior for detection of pancreatic lesions compared with standard imaging in patients with multiple endocrine neoplasia type 1. Gastrointest Endosc. 2015;81(1):159-167.e2.
van Asselt, S. J., Brouwers, A. H., van Dullemen, H. M., van der Jagt, E. J., Bongaerts, A. H., Kema, I. P., Koopmans, K. P., Valk, G. D., Timmers, H. J., de Herder, W. W., Feelders, R. A., Fockens, P., Sluiter, W. J., de Vries, E. G., & Links, T. P. (2015). EUS is superior for detection of pancreatic lesions compared with standard imaging in patients with multiple endocrine neoplasia type 1. Gastrointestinal Endoscopy, 81(1), 159-e2. https://doi.org/10.1016/j.gie.2014.09.037
van Asselt SJ, et al. EUS Is Superior for Detection of Pancreatic Lesions Compared With Standard Imaging in Patients With Multiple Endocrine Neoplasia Type 1. Gastrointest Endosc. 2015;81(1):159-167.e2. PubMed PMID: 25527055.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - EUS is superior for detection of pancreatic lesions compared with standard imaging in patients with multiple endocrine neoplasia type 1. AU - van Asselt,Sophie J, AU - Brouwers,Adrienne H, AU - van Dullemen,Hendrik M, AU - van der Jagt,Eric J, AU - Bongaerts,Alfons H H, AU - Kema,Ido P, AU - Koopmans,Klaas P, AU - Valk,Gerlof D, AU - Timmers,Henri J, AU - de Herder,Wouter W, AU - Feelders,Richard A, AU - Fockens,Paul, AU - Sluiter,Wim J, AU - de Vries,Elisabeth G E, AU - Links,Thera P, PY - 2014/05/26/received PY - 2014/09/10/accepted PY - 2014/12/21/entrez PY - 2014/12/21/pubmed PY - 2015/8/19/medline SP - 159 EP - 167.e2 JF - Gastrointestinal endoscopy JO - Gastrointest Endosc VL - 81 IS - 1 N2 - BACKGROUND: In multiple endocrine neoplasia type 1 (MEN1), pancreatic neuroendocrine tumors (pNETs) are the leading MEN1-related cause of death. OBJECTIVE: To evaluate EUS and (11)C-5-hydroxytryptophan positron emission tomography ((11)C-5-HTP PET), compared with the recommended screening techniques in MEN1 patients for early detection of pNETs. DESIGN: Cross-sectional study. SETTING: Tertiary-care university medical center. PATIENTS: This study involved 41 patients with a proven MEN1 mutation or with one MEN1 manifestation and a mutation carrier as a first-degree family member, with recent screening by abdominal CT or magnetic resonance imaging (MRI) and somatostatin receptor scintigraphy (SRS). INTERVENTIONS: EUS by using a linear Pentax echoendoscope and Hitachi EUB-525 and (11)C-5-HTP PET. MAIN OUTCOME MEASUREMENTS: Patient-based and lesion-based positivity for pNET was calculated for all imaging techniques. The McNemar test was used to compare the yield of the 4 imaging techniques. RESULTS: In 35 of 41 patients, 107 pancreatic lesions were detected in total. EUS detected 101 pancreatic lesions in 34 patients, (11)C-5-HTP PET detected 35 lesions in 19 patients, and CT/MRI + SRS detected 32 lesions in 18 patients (P < .001). (11)C-5-HTP PET performed similarly to CT/MRI + SRS and better compared with SRS only (13 lesions in 12 patients), both at a patient-based and lesion-based level (P < .05). LIMITATIONS: Single-center study. CONCLUSION: EUS is superior to CT/MRI + SRS for pancreatic lesion detection in patients with MEN1. In this setting, (11)C-5-HTP PET is not useful. We recommend EUS as the first-choice pancreas imaging technique in patients with MEN1. ( CLINICAL TRIAL REGISTRATION NUMBER: NTR1668.). SN - 1097-6779 UR - https://www.unboundmedicine.com/medline/citation/25527055/EUS_is_superior_for_detection_of_pancreatic_lesions_compared_with_standard_imaging_in_patients_with_multiple_endocrine_neoplasia_type_1_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(14)02257-3 DB - PRIME DP - Unbound Medicine ER -