OBJECTIVE: In the present study, the diagnostic value of somatostatin
receptor scintigraphy (SRS) was evaluated in the preoperative workup in
patients with pancreatic duct cancers and islet cell tumors, as well as in
the follow-up of these patients. METHODS: Twenty-six patients with
suspected primary pancreatic duct cancers and 48 patients with islet cell
tumors were studied. The SRS was performed using the radionuclide-labeled
somatostatin analogue 111In-octreotide. Another group of 12 patients who
were still alive more than 3 years after pancreaticoduodenectomy for
pancreatic duct adenocarcinomas also underwent SRS. RESULTS: In 31 (65%)
of 48 patients, the primary pancreatic islet cell tumor as well as its
often previously not yet recognized metastases could be visualized. In
contrast, none of the 26 pancreatic adenocarcinomas or their metastases
could be seen. In 5 of 12 patients who were alive more than 3 years after
pancreaticoduodenectomy for pancreatic duct adenocarcinomas, metastatic
lesions were visualized at SRS. In retrospect, these patients were not
operated on for adenocarcinomas but for "nonfunctioning" islet cell
tumors. CONCLUSIONS: The present study supports the concept that SRS has a
place in the preoperative differential diagnosis of islet cell tumors and
pancreatic duct cancers as well as in the follow-up, especially in those
cases in which no tumor histologic analysis was obtained, or the
pathologic examination of the tumor tissue had not included special
staining procedures for neuroendocrine characteristics. Our results also
indicate that the evaluation of the results of investigations on the role
of surgery or radiation therapy and chemotherapy or both in pancreatic
duct cancer have to be interpreted with caution, if no histologic analysis
and staining for neuroendocrine characteristics was performed
