USEFULNESS OF SOMATOSTATIN RECEPTOR SCINTIGRAPHY IN THE MANAGEMENT OFPATIENTS WITH ZOLLINGER-ELLISON-SYNDROME

Background - Management of patients with Zollinger-Ellison syndrome (Z ES) depends on the presence of multiple endocrine neoplasia type 1 (ME N 1) or liver metastases, or both. Somatostatin receptor scintigraphy (SRS) detects previously unknown endocrine tumours. Aim and methods - To evaluate SRS findings susceptible to modifying the management of pa tients with ZES - that is, relevant findings, and the specificity of t hese findings. The latter were defined according to our current therap eutic strategy in three subgroups of patients (sporadic, MEN 1, and li ver metastases). Patients - 85 consecutive patients without known extr a-abdominal metastases were studied between September 1991 and March 1 996. Results - Relevant findings were found in 41% of 49 patients with sporadic disease but without liver metastases, in 22% of 18 patients with MEN 1 but without liver metastases, and in 17% of 18 patients wit h liver metastases. Follow up was available for 20 (74%) of 27 patient s who had 23 relevant findings. Nineteen relevant findings (83%) were confirmed at a median of three (range 0.25-45) months of follow up; fo ur (17%) were not confirmed at 30 (range 12-52) months (p=0.025). Find ings located in the duodenopancreatic area (90%), chest (100%), bone ( 100%), and Liver (60%) were confirmed. Most findings for patients with MEN 1 involved the chest. Conclusion - SRS detects many anomalies sus ceptible to modifying management of patients with ZES, especially in t hose with sporadic disease. The specificity of hot spots located outsi de the Liver seems very high. By contrast, the specificity of hot spot s located in the liver remains to be evaluated when conventional imagi ng is negative.