Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2018) 60 P30 | DOI: 10.1530/endoabs.60.P30

1University Hospital Aintree, Liverpool, UK; 2The Christie, Manchester, UK; 3King’s College Hospital, London, UK; 4Royal Liverpool Hospital, Liverpool, UK.


Background: Pancreatic neuroendocrine tumours (panNETs) may arise as part of an underlying genetic condition such as multiple endocrine neoplasia type 1 (MEN type 1). The value of functional imaging using 68Ga-labelled synthetic octreotide analogues using PET-CT has not been extensively evaluated in patients with MEN1 to determine its value.

Methods: We investigated the effect of 68Ga-based PET-CT imaging on patient management in patients with a clinically suspected or histologically confirmed familial panNET. A retrospective electronic case note study was carried out in three ENETS Centres (Aintree/Royal Liverpool, Christie Hospital, Manchester and King’s College Hospital, London). Patients who had undergone a 68Ga based PET-CT scan for a panNET were identified using a prospectively populated list.

Results: We collected data for 52 patients (25 male, 27 female) with mean (SD) age of 50 (17) years; MEN type 1 was the predominant syndrome in 87% (n=45). 94% (n=48) were still alive and 6% (n=3) dead (1 missing). 42% (n=21) were non-functional tumours versus 58% (n=29) with functional tumours. A confirmed histological diagnosis (from biopsy/surgical resection) was available in 86% of patients (n=44) with imaging in the remainder. Tumours were in the head/neck, body, tail or were multi-focal in 38, 6, 28 and 28% of cases. Of those with histological grade available (n=32): 53% were Grade 1 tumours (n=17), 44% (n=14) were Grade 2 tand 3% (1) were Grade 3. 68% (n=34) were localised, 18% (n=9) were locally advanced and 14% (n=7) were metastatic. The indications for Ga68 PET-CT scans were diagnosis/staging 50% (n=26), post-operative assessment/clinical surveillance 46% (n=24) and consideration for peptide receptor radionuclide therapy (PRRT) 4% (n=2). In 75% of cases (n=39) tracer avid uptake was seen with no uptake in 25% (n=13). In 48% of cases the scan confirmed information gained from other imaging modalities but in 33% of cases it identified new sites of disease and in 4% ruled out suspected disease with previous imaging. Overall, Ga68 based PET-CT imaging led to change in management in 40% (n=21) of cases.

Conclusion: 68Ga-based imaging in patients with familial panNETs provides supplementary clinical information that guides diagnosis, staging, and most appropriate treatment.

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