Annals of Oncology 14:586-591, 2003
© 2003 European Society for Medical Oncology
Original Paper |
Staging of digestive endocrine tumours using helical computed tomography and somatostatin receptor scintigraphy
Departments of 1 Digestive and Liver Disease, 3 Radiology and 5 Nuclear Medicine, University "La Sapienza", Roma; 2 Department of Surgery, University of Verona, Verona; 4 Department of Nuclear Medicine, National Cancer Institute, Roma; 6 Department of Pathology, University of Parma, Parma, Italy
Received 22 August 2002; revised 23 October 2002; accepted 21 November 2002
Background:
In patients with digestive endocrine tumours, complete pre-operative staging is essential in planning proper management and evaluating treatment efficacy. To date, somatostatin receptor scintigraphy (SRS) is considered the ‘gold standard’ imaging procedure, and very few data are available concerning the use of helical computed tomography (hCT). This study aimed to determine the diagnostic accuracy and the ability to modify the surgical management of hCT, alone or combined with SRS.
Patients and methods:
Sixty patients were staged before surgery by hCT, SRS and tumour markers, and included in group 1 if suitable for radical surgery, otherwise in group 2. All patients underwent laparotomy followed by subsequent re-staging.
Results:
SRS sensitivity was 77%, 48% and 67% for primary, lymph-node and liver lesions, respectively. hCT sensitivity was 94%, 69% and 94% for primary, lymph-node and liver lesions, respectively (P = 0.02 versus SRS, for liver lesions). During pre-operative evaluation, hCT correctly staged 92% and SRS 75% of patients (P = 0.02). hCT provided additional information in 17% of patients.
Conclusions:
Since hCT has been shown to be extremely accurate, providing essential information for the planning of surgical treatment compared with that of SRS, both techniques should be used in the pre-operative work-up of digestive endocrine tumours.
Key words: digestive endocrine tumours, helical computed tomography, management, somatostatin receptor scintigraphy, staging
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