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Detection of liver metastases from endocrine tumors

MRI has an edge over CT and somatostatin receptor scintigraphy for the detection of liver metastases from endocrine tumors, finds a report in the most recent Journal of Clinical Oncology which recommends the systematic performance of liver MRI at the initial staging of well-differentiated gastroenteropancreatic endocrine tumors.

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Dr Dromain and colleagues from France designed a study to compare the respective sensitivity of somatostatin receptor scintigraphy (SRS), computed tomography (CT), and magnetic resonance imaging (MRI) in the detection of liver metastases.

The researchers recruited patients with well-differentiated gastroenteropancreatic endocrine tumors (WDGEP ET).

The research team aimed to find the predictive factors for "high-sensitivity SRS."

In total, the researchers recruited 64 patients with WDGEP ET who underwent SRS with abdominal single-photon emission computed tomography (SPECT), spiral CT, and 1.5-T MRI within a 15-day interval, the order of which was randomized.

2 readers analyzed images of each modality, blindly and independently.

The researchers found hepatic metastases in 40 of the 64 patients and this was confirmed by pathology after liver biopsy or surgery in 32 and 8 patients, respectively.

More lesions were detected in 10 patients by SPECT compares with static views
Journal of Clinical Oncology

The research team noted that SRS, CT, and MRI detected a total of 204, 325, and 394 metastases, respectively.

The researchers found that the number of detected metastases was significantly higher with MRI than with CT and SRS and higher with CT than with SRS.

In addition, the team found that SRS was negative in 7 patients with a positive CT and/or MRI.

More lesions were detected in 10 patients by single-photon emission CT compared with static views.

The median metastasis size was significantly correlated with the sensitivity of SRS.

Dr Dromain concluded, "MRI seems to have an edge over CT and SRS for the detection of liver metastases from endocrine tumors."

"We recommend the systematic performance of liver MRI at WDGEP ET initial staging and before major therapeutic events."

"The low performance of SRS was mainly explained by the impact of the metastasis size on the detection capacity of SRS."

Journal of Clinical Oncology; 2005: 23 (1): 70-78
10 January 2005

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