(dtpa-phe(1))-octreotide and Hemangioma

Topics: Hemangioma; Humans; Hypophosphatemia; Indium Radioisotopes; Male; Middle Aged; Neoplasms; Octreotide; Osteomalacia; Pentetic Acid; Positron-Emission Tomography; Receptors, Somatostatin; RNA, Messenger; Tomography, X-Ray Computed

To compare somatostatin-receptor scintigraphy and conventional imaging modalities in the differentiation of small hepatic hemangiomas from small liver metastases in Zollinger-Ellison syndrome.. Twenty-nine patients had hypervascular liver lesions smaller than 2 cm that could have been either metastases or hemangiomas. Fourteen patients had metastases, 14 had hemangiomas, and one had both. Scintigraphy was compared with computed tomography (CT), magnetic resonance (MR) imaging, and angiography for the correct identification of the lesions.. The hemangiomas and liver metastases both had a mean size of 1.3 cm. In the patients with hepatic hemangiomas, scintigraphy showed no lesions. CT, angiography, or MR imaging showed a lesion in 40%-93%. With metastases present, any liver lesion was detected in 93% with scintigraphy versus 20%-60% with another modality. Scintigraphy depicted liver metastases in 93% of patients, which was higher than the sensitivities of other modalities. The accuracy (96%) and positive (100%) and negative (93%) predictive values of scintigraphy for detecting liver metastases were superior to those of other modalities. There were 45 liver metastases and 31 hemangiomas; a per lesion analysis gave results similar to the per patient analysis results.. In Zollinger-Ellison syndrome, somatostatin-receptor scintigraphy provides an excellent diagnostic tool to differentiate small hepatic hemangiomas from small liver metastases.

Topics: Adult; Aged; Diagnosis, Differential; Female; Gastrinoma; Hemangioma; Humans; Indium Radioisotopes; Liver Neoplasms; Male; Middle Aged; Octreotide; Pancreatic Neoplasms; Pentetic Acid; Predictive Value of Tests; Radionuclide Imaging; Radiopharmaceuticals; Receptors, Somatostatin; Sensitivity and Specificity

We report a case of a hepatic carcinoid metastasis mimicking a hemangioma on ultrasound and on CT. Indium-111-DTPA-D-Phe-1-octreotide (111In-OCT) and 123I-vasoactive intestinal peptide (123I-VIP) receptor images suggested a carcinoid metastasis of the liver. The final diagnosis was established histopathologically. The differential diagnosis of liver lesions is discussed.

Topics: Carcinoid Tumor; Diagnosis, Differential; Female; Hemangioma; Humans; Indium Radioisotopes; Iodine Radioisotopes; Liver Neoplasms; Middle Aged; Octreotide; Pentetic Acid; Radiopharmaceuticals; Receptors, Somatostatin; Receptors, Vasoactive Intestinal Peptide; Tomography, Emission-Computed, Single-Photon