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Research Article| Volume 116, ISSUE 6, P1139-1147, December 1994

Detection of occult gastrinomas with iodine 125-labeled lanreotide and intraoperative gamma detection

  • Eugene A. Woltering
    Correspondence
    Reprint requests: Eugene A. Woltering, MD, FAGS, Professor of Surgery, Department of Surgery, Louisiana State University School of Medicine, 1542 Tulane Ave., New Orleans, LA 70112.
    Affiliations
    From the Department of Surgery, Section of Surgical Endocrinology, Louisiana State University, New Orleans, La., USA

    Department of Surgery, Section of Surgical Endocrinology, and Department of Radiology, Division of Nuclear Medicine, The Oregon Health Sciences University, Portland, Ore., USA

    Department of Medicine, Division of Endocrinology, and Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
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  • Rosemary Barrie
    Affiliations
    From the Department of Surgery, Section of Surgical Endocrinology, Louisiana State University, New Orleans, La., USA

    Department of Surgery, Section of Surgical Endocrinology, and Department of Radiology, Division of Nuclear Medicine, The Oregon Health Sciences University, Portland, Ore., USA

    Department of Medicine, Division of Endocrinology, and Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
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  • Thomas M. O'Dorisio
    Affiliations
    From the Department of Surgery, Section of Surgical Endocrinology, Louisiana State University, New Orleans, La., USA

    Department of Surgery, Section of Surgical Endocrinology, and Department of Radiology, Division of Nuclear Medicine, The Oregon Health Sciences University, Portland, Ore., USA

    Department of Medicine, Division of Endocrinology, and Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
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  • M. Sue O'Dorisio
    Affiliations
    From the Department of Surgery, Section of Surgical Endocrinology, Louisiana State University, New Orleans, La., USA

    Department of Surgery, Section of Surgical Endocrinology, and Department of Radiology, Division of Nuclear Medicine, The Oregon Health Sciences University, Portland, Ore., USA

    Department of Medicine, Division of Endocrinology, and Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
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  • Robert Nance
    Affiliations
    From the Department of Surgery, Section of Surgical Endocrinology, Louisiana State University, New Orleans, La., USA

    Department of Surgery, Section of Surgical Endocrinology, and Department of Radiology, Division of Nuclear Medicine, The Oregon Health Sciences University, Portland, Ore., USA

    Department of Medicine, Division of Endocrinology, and Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
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  • David M. Cook
    Affiliations
    From the Department of Surgery, Section of Surgical Endocrinology, Louisiana State University, New Orleans, La., USA

    Department of Surgery, Section of Surgical Endocrinology, and Department of Radiology, Division of Nuclear Medicine, The Oregon Health Sciences University, Portland, Ore., USA

    Department of Medicine, Division of Endocrinology, and Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
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DOI:https://doi.org/10.5555/uri:pii:0039606094903166
Detection of occult gastrinomas with iodine 125-labeled lanreotide and intraoperative gamma detection
Previous ArticleRole of endoscopic ultrasonography in the localization of insulinomas and gastrinomas
Next ArticlePostreceptor signal transduction mechanisms involved in octreotide-induced inhibition of angiogenesis
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      Abstract

      Background. Surgical exploration for gastrinoma has a high failure rate because of small primary tumors and occult metastasis. Despite extensive preoperative and Intraoperative tumor localization, only 30% to 40% of patients with gastrinoma are cured by surgery. Two patients with unlocalized gastrinomas were studied with Intraoperative gamma detection of an iodine 125-labeled somatostatin analog, lanreotide, to localize their tumors.
      Methods. Both patients were challenged before operation with 100 μg of octreotide acetate, and both had circulating gastrin levels suppressed by greater than 50%. Iodine 125-labeled lanreotide (100 to 150 μCi) was injected during exploration, and an Intraoperative gamma detector was used to detect tumor binding of the analog.
      Results. In patient 1 a single source of increased counts was discovered in a retroduodenal lymph node, which was excised, no other tissue was removed. Histologic study of this node failed to demonstrate tumor; however, the patient's gastrin level was normal (63 pg/ml) 4 months after operation. In patient 2 five areas of increased counts were discovered and excised. Three of these five areas had visible tumor on microscopic examination. Three months after operation the patient's fasting gastrin level was 103 pg/ml.
      Conclusions. Intraoperative gamma detection of radiolabeled peptides may allow the localization of occult tumors that contain specific peptide receptors.
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      Article info

      Footnotes

      ☆Supported in part by The Oregon Health Sciences University Surgical Endocrinology Development Fund.

      ☆☆Presented at the Fifteenth Annual Meeting of the American Association of Endocrine Surgeons, Dearborn, Mich., April 17–19, 1994.

      Identification

      DOI: https://doi.org/10.5555/uri:pii:0039606094903166

      Copyright

      © 1994 Published by Elsevier Inc.

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