shu-508 and Neuroendocrine-Tumors

The echo-enhanced Power-Doppler sonography is useful for the differential diagnosis of pancreatic tumours. Tumour criteria for the differentiation of pancreatic tumours with this procedure are explained using selected cases in the present publication. Ductal carcinomas are often hypovascularised compared with the surrounding tissue. On the other hand, neuroendocrine tumours are hypervascularised lesions. Tumours associated with pancreatitis have a different vascularisation pattern depending on inflammation and necrosis. Cystadenomas frequently show many vessels along the fibrotic strands.. Pancreatic tumours have different vascularisation patterns in the echo-enhanced Power-Doppler sonography. These characteristics can be used for the differential diagnosis.

Topics: Adenocarcinoma; Contrast Media; Cystadenoma; Diagnosis, Differential; Humans; Image Enhancement; Neoplasm Invasiveness; Neovascularization, Pathologic; Neuroendocrine Tumors; Pancreatic Neoplasms; Pancreatitis; Polysaccharides; Ultrasonography, Doppler, Color

To assess the vascularization of neuroendocrine tumors by stimulated acoustic emission (SAE) of SH U 508A during the blood pool phase in comparison with contrast-enhanced Doppler sonography.. Thirty-six patients with neuroendocrine tumors received contrast-enhanced Doppler sonography and 21, an additional SAE. To classify tumor perfusion on Doppler sonography, a 4-step rating score was introduced: (1) no vessels (hypoperfusion); (2) one feeding or central vessel (hypoperfusion); (3) some vessels (hyperperfusion); and (4) disseminated vessels (hyperperfusion). In 36 patients, 1 pancreatic primary tumor, 33 liver metastases, 1 splenic metastasis, and 1 lymph node metastasis were examined. Results were correlated with biphasic spiral CT (n = 35) and angiography (n = 2).. Arterial-phase CT and digital subtraction angiography revealed 18 hyper- and 18 hypoperfused lesions. Contrast-enhanced Doppler correctly classified 15 of 18 patients (83%) with hyperperfused lesions as well as 16 of 18 (89%) hypoperfused tumors by applying the rating score. SAE correctly identified 4 of 9 hyperperfused lesions (44%), 2 were isoperfused compared with normal liver tissue (22%), and 3 were hypoperfused (33%). Of 12 hypoperfused lesions, 11 were classified correctly (92%), and 1 showed isoperfusion. Hence, the positive and negative predictive values for SAE were 80% and 69%, respectively. For contrast-enhanced Doppler sonography, positive and negative predictive values were 88% and 84%, respectively.. Blood pool SAE failed to determine subtle tumor perfusion correctly. The rating score for contrast-enhanced Doppler sonography characterized tumor perfusion with high accuracy. The use of a contrast agent significantly improved perfusion characterization.

Topics: Angiography, Digital Subtraction; Contrast Media; Humans; Male; Neuroendocrine Tumors; Polysaccharides; Predictive Value of Tests; Tomography, X-Ray Computed; Ultrasonography, Doppler, Color