Nuclear medicine in the detection and management of pancreatic islet-cell tumours

Best Pract Res Clin Endocrinol Metab. 2005 Jun;19(2):213-27. doi: 10.1016/j.beem.2004.09.001.


Over the last decade somatostatin receptor scintigraphy using various derivatives of long-acting somatostatin analogues has gained its place in the management of pancreatic islet-cell tumours. Scintigraphy is based on the high-affinity binding of such somatostatin analogues to receptors over-expressed by these tumour types. Following the introduction of (111)In-DTPA-D-Phe(1)-octreotide, clinical studies with radiolabelled DOTA-Tyr(3)-octreotide and DOTA-Tyr(3)-octreotate derivatives have shown considerable improvement of imaging results with increased tumour uptake. One of the newer developments, (68)Ga-labelled DOTA-Tyr(3)-octreotide, has shown promising results in patients with pancreatic islet-cell tumours, based on the high-affinity binding to the somatostatin receptor subtype 2 in combination with positron emission tomography (PET) technology. Other peptides--such as ligands for the gastrin/CCK2 receptors or vasoactive intestinal peptide (VIP)--have also been studied for imaging pancreatic cell tumours. Whereas small-sized gastrinoma, somatostatinoma, glucagonoma, carcinoid and VIPoma are frequently detected by somatostatin receptor scintigraphy, insulinoma may escape detection due to reduced receptor expression. Following peptide receptor scintigraphy, a change in patient management is reported in up to 30% of patients. When labelled with (90)Y or (177)Lu, some somatostatin analogues have been applied to patients in advanced stages of the disease. Despite positive response data in 50% of patients, long-term results and survival rates are lacking.

Publication types

  • Review

MeSH terms

  • Adenoma, Islet Cell / diagnostic imaging*
  • Adenoma, Islet Cell / radiotherapy*
  • Female
  • Humans
  • Islets of Langerhans / diagnostic imaging*
  • Male
  • Nuclear Medicine / methods
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / radiotherapy*
  • Radionuclide Imaging
  • Radiopharmaceuticals / therapeutic use
  • Somatostatin / analogs & derivatives


  • Radiopharmaceuticals
  • Somatostatin