Images of a patient with a metastatic insulinoma before and after chemotherapy.
Images above are acquired with 123I octreotide: the upper left image is an anterior view of the abdomen showing the liver outline with some activity in the gall bladder and gut; the upper right image is a posterior view showing the metastatic site (M indicates the tumour) in the posterior part of the liver. Below are images acquired with In, octreotide after chemotherapy. The lower left image is an anterior view of the abdomen showing the liver (L), spleen (S) and a metastatic site (M) in the left lobe of the liver. Some activity is noted in the kidneys since this is the normal route of excretion for this agent. The lower right image is a posterior view of the abdomen showing the liver (L), spleen (S) and kidney (K). Note that the lesion in the posterior part of the liver, detected with 123I octreotide prior to chemotherapy (upper right), shows complete regression. A majority of gastroendocrine tumours have somatostatin receptors and can be imaged with radiolabelled octreotide. This technique can be used to image insulinomas, carcinoids, vipomas and gastrinomas in principle and to assess these tumours before and after therapy.
