EUS is superior for detection of pancreatic lesions compared with standard imaging in patients with multiple endocrine neoplasia type 1

van Asselt, S. J., Brouwers, A. H., van Dullemen, H. M., van der Jagt, E. J., Bongaerts, A. H. H., Kema, I. P., Koopmans, K. P., Valk, G. D., Timmers, H. J., de Herder, W. W., Feelders, R. A., Fockens, P., Sluiter, W. J., de Vries, E. G. E. & Links, T. P., Jan-2015, In : Gastrointestinal endoscopy. 81, 1, p. 159-167.e2 11 p.

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  • EUS is superior for detection of pancreatic lesions compared with standard imaging

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Background: In multiple endocrine neoplasia type 1 (MEN1), pancreatic neuroendocrine tumors (pNETs) are the leading MEN1-related cause of death.

Objective: To evaluate EUS and C-11-5-hydroxytryptophan positron emission tomography (C-11-5-HTP PET), compared with the recommended screening techniques in MEN1 patients for early detection of pNETs.

Design: Cross-sectional study.

Setting: Tertiary-care university medical center.

Patients: This study involved 41 patients with a proven MEN1 mutation or with one MEN1 manifestation and a mutation carrier as a first-degree family member, with recent screening by abdominal CT or magnetic resonance imaging (MRI) and somatostatin receptor scintigraphy (SRS).

Interventions: EUS by using a linear Pentax echoendoscope and Hitachi EUB-525 and C-11-5-HTP PET.

Main Outcome Measurements: Patient-based and lesion-based positivity for pNET was calculated for all imaging techniques. The McNemar test was used to compare the yield of the 4 imaging techniques.

Results: In 35 of 41 patients, 107 pancreatic lesions were detected in total. EUS detected 101 pancreatic lesions in 34 patients, C-11-5-HTP PET detected 35 lesions in 19 patients, and CT/MRI + SRS detected 32 lesions in 18 patients (P <.001). C-11-5-HTP PET performed similarly to CT/MRI + SRS and better compared with SRS only (13 lesions in 12 patients), both at a patient-based and lesion-based level (P <.05).

Limitations: Single-center study.

Conclusion: EUS is superior to CT/MRI + SRS for pancreatic lesion detection in patients with MEN1. In this setting, C-11-5-HTP PET is not useful. We recommend EUS as the first-choice pancreas imaging technique in patients with MEN1.

Original languageEnglish
Pages (from-to)159-167.e2
Number of pages11
JournalGastrointestinal endoscopy
Issue number1
Publication statusPublished - Jan-2015



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