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

Eugene A. Woltering, Rosemary Barrie, Thomas M. O'Dorisio, M. Sue O'Dorisio, Robert Nance, David M. Cook

Research output: Contribution to journalArticle

40 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1139-1147
Number of pages9
JournalSurgery
Volume116
Issue number6
StatePublished - 1994

Fingerprint

Gastrinoma
Iodine
Gastrins
Neoplasms
Octreotide
Peptide Receptors
lanreotide
Somatostatin
Fasting
Lymph Nodes
Neoplasm Metastasis
Peptides

ASJC Scopus subject areas

  • Surgery

Cite this

Woltering, E. A., Barrie, R., O'Dorisio, T. M., Sue O'Dorisio, M., Nance, R., & Cook, D. M. (1994). Detection of occult gastrinomas with iodine 125-labeled lanreotide and intraoperative gamma detection. Surgery, 116(6), 1139-1147.

Detection of occult gastrinomas with iodine 125-labeled lanreotide and intraoperative gamma detection. / Woltering, Eugene A.; Barrie, Rosemary; O'Dorisio, Thomas M.; Sue O'Dorisio, M.; Nance, Robert; Cook, David M.

In: Surgery, Vol. 116, No. 6, 1994, p. 1139-1147.

Research output: Contribution to journalArticle

Woltering, EA, Barrie, R, O'Dorisio, TM, Sue O'Dorisio, M, Nance, R & Cook, DM 1994, 'Detection of occult gastrinomas with iodine 125-labeled lanreotide and intraoperative gamma detection', Surgery, vol. 116, no. 6, pp. 1139-1147.
Woltering EA, Barrie R, O'Dorisio TM, Sue O'Dorisio M, Nance R, Cook DM. Detection of occult gastrinomas with iodine 125-labeled lanreotide and intraoperative gamma detection. Surgery. 1994;116(6):1139-1147.
Woltering, Eugene A. ; Barrie, Rosemary ; O'Dorisio, Thomas M. ; Sue O'Dorisio, M. ; Nance, Robert ; Cook, David M. / Detection of occult gastrinomas with iodine 125-labeled lanreotide and intraoperative gamma detection. In: Surgery. 1994 ; Vol. 116, No. 6. pp. 1139-1147.
@article{768d8633e61542a7bd90264d96cdf9cf,
title = "Detection of occult gastrinomas with iodine 125-labeled lanreotide and intraoperative gamma detection",
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.",
author = "Woltering, {Eugene A.} and Rosemary Barrie and O'Dorisio, {Thomas M.} and {Sue O'Dorisio}, M. and Robert Nance and Cook, {David M.}",
year = "1994",
language = "English (US)",
volume = "116",
pages = "1139--1147",
journal = "Surgery (United States)",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Detection of occult gastrinomas with iodine 125-labeled lanreotide and intraoperative gamma detection

AU - Woltering, Eugene A.

AU - Barrie, Rosemary

AU - O'Dorisio, Thomas M.

AU - Sue O'Dorisio, M.

AU - Nance, Robert

AU - Cook, David M.

PY - 1994

Y1 - 1994

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0028114310&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028114310&partnerID=8YFLogxK

M3 - Article

C2 - 7985099

AN - SCOPUS:0028114310

VL - 116

SP - 1139

EP - 1147

JO - Surgery (United States)

JF - Surgery (United States)

SN - 0039-6060

IS - 6

ER -