68 Ga-DOTA-TOC-PET/CT detects heart metastases from ileal neuroendocrine tumors
- PDF / 287,328 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 26 Downloads / 158 Views
ORIGINAL ARTICLE
68
Ga-DOTA-TOC-PET/CT detects heart metastases from ileal neuroendocrine tumors
Jan Calissendorff • Anders Sundin Henrik Falhammar
•
Received: 9 August 2013 / Accepted: 29 October 2013 Ó Springer Science+Business Media New York 2013
Abstract Metastases from ileal neuroendocrine tumors (NETs) to the myocardium are rare and generally seen in patients with widespread metastatic NET disease. The objectives of this investigation were to describe the frequency of intracardiac metastases in ileal NET patients examined by 68Ga-DOTA-TOC-PET/CT and to describe the cases in detail. All 68Ga-DOTA-TOC-PET/CT examinations performed at the Karolinska University Hospital since 2010 until April 2012 were reviewed. In all, 128 out of 337 examinations were in patients with ileal NETs. Four patients had seven myocardiac metastases, yielding a frequency of 4.3 % in patients with ileal NETs. One patient had cardiac surgery while three were treated with somatostatin analogs. The cardiac metastases did not affect the patients’ activity of daily life. 68Ga-DOTA-TOC-PET/ CT is an established imaging modality in identifying cardiac metastases in ileal NETs. Prospective studies are needed to confirm the true clinical value of 68Ga-DOTA-
J. Calissendorff (&) Endocrine Section, VO Internmedicin, Department of Clinical Science and Education, Karolinska Institutet, So¨dersjukhuset, Sjukhusbacken 10, 118 83 Stockholm, Sweden e-mail: [email protected] A. Sundin H. Falhammar Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden A. Sundin Department of Radiology, Karolinska University Hospital, Stockholm, Sweden H. Falhammar Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
TOC-PET/CT in detecting cardiac metastases in both ileal and non-ileal NETs. Keywords Imaging DOTA-TOC-PET/CT Heart metastases Neuroendocrine tumors
Introduction Ileal neuroendocrine tumors (NETs) metastasize mainly to lymph nodes and the liver and less frequently to bone and lung [1, 2]. Patients with liver metastases from ileal NETs often develop the carcinoid syndrome, i.e., flush and diarrhea, secondary to increased levels of serotonin. The serotonin is responsible for carcinoid heart disease in the right-sided heart leaflets [3, 4]. Ileal NETs increase in incidence [5], but if this represents a true increase or is an effect of better diagnostic procedures is unknown. Metastases to the myocardium from ileal NETs are very uncommon similar to in other NETs, i.e., bronchial [6, 7], gallbladder [8], and ovarian NETs [9–11]. Cardiac metastases can be localized to the pericardium [12], atrium [13], and within the myocardium [14–16]. In ileal NETs, myocardiac metastases have historically been described in patients with long-standing disease, combined with liver metastases and the carcinoid syndrome [16]. The incidence has been reported to be 2–4 % [15, 16]. Cardiac metastases have previously been difficult to depict by conventional radiological te
Data Loading...
