RSS Feeds
Somatostatin Receptor Scintigraphy in the Zollinger-Ellison Syndrome
- Donato Ciaccia, MD; and
- Frank G. Gress, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
We read with great interest the article by Gibril and coworkers [1] on the use of somatostatin receptor scintigraphy (SRS) for the detection of primary and metastatic gastrinomas in patients with the Zollinger-Ellison syndrome. The authors report a 58% sensitivity for diagnosing primary gastrinomas; this sensitivity was much higher than those of other methods-computed tomography, magnetic resonance imaging, angiography, and transabdominal ultrasonography.
However, we were surprised by the authors' failure to mention endoscopic ultrasonography (EUS) as the foremost diagnostic method for the localization of functioning islet cell tumors. The sensitivity of EUS for localization of hormonally active islet cell tumors has ranged from 57% to 100%, with a cumulative sensitivity of approximately 80% [2, 3]. In the diagnosis of primary gastrinomas, EUS has a reported sensitivity of 86% [4]. It can also detect local regional adenopathy. The downside is that EUS cannot adequately visualize the right lobe of the liver, and it is not useful for the detection of distant metastases other than those to the liver.
In addition, the advent of EUS-guided fine-needle aspiration biopsy [5] now allows localization, staging, and direct cytologic confirmation of suspected neuroendocrine tumors (Ciaccia D, Gress FG. Unpublished data). In academic health centers, where patients suspected of having active neuroendocrine tumors might be referred, EUS is becoming more widely available. Both the accuracy and availability of EUS should prompt physicians to consider it as the first diagnostic study in patients suspected of having a hormonally active islet cell tumor that is not metastatic. A study comparing SRS and EUS as diagnostic methods for the localization of islet cell tumors is needed. The omission of this information seriously detracts from what is otherwise an important paper in the management of gastrinomas and other islet cell tumors.
Donato Ciaccia, MD
Frank G. Gress, MD
Indiana University Medical Center; Indianapolis, IN 46202
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
