Original articleClinical endoscopyEUS is superior for detection of pancreatic lesions compared with standard imaging in patients with multiple endocrine neoplasia type 1
Section snippets
Patients
In this prospective study, treating physicians in the MEN1 centers at the University Medical Centers of Rotterdam, Utrecht, Nijmegen, and Groningen referred patients to the University Medical Center Groningen for study participation. Patients were included between February 2009 and August 2011. Eligible were those with genetically proven MEN1 or patients with clinically proven MEN1 with a first-degree family member with genetically confirmed MEN1, aged ≥18 years. Standard MEN1 screening had to
Patient characteristics
In total, 41 patients with MEN1 were recruited for study participation. Characteristics of the included patients are shown in Table 1. The 41 patients carried 19 different MEN1 mutations (Supplementary Table 1, available online at www.giejournal.org).
MEN1 conventional screening
With conventional screening, ≥1 pancreatic lesions were detected by CT or MRI in 14 patients (34%), by SRS in 12 patients (29%), and by CT or MRI + SRS in 18 patients (44%). Of the 23 patients with CT and the 18 with MRI, 9 (39%) and 6 (33%)
Discussion
This is the first imaging study in patients with MEN1 in which a prospective head-to-head comparison of EUS and 11C-5-HTP PET was performed relative to the standard screening for pNET detection. Compared with CT and/or MRI and SRS—separately or combined—EUS is superior for early detection of pancreatic lesions at both a patient-based and lesion-based level. In this screening setting, 11C-5-HTP PET is not useful.
Prominent in this study is the excellent performance of EUS. In our detailed
Acknowledgments
We would like to thank Drs D.J. Gouma and D. O’Toole for their contributions as members of the external monitoring committee.
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DISCLOSURE: Supported by a grant of the Dutch Cancer Society (RUG 2008-4188). All other authors disclosed no financial relationships relevant to this article.
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See CME section; p. 214.