Neuroendocrine Tumours Clinical Trial
Official title:
Accuracy and Clinical Impact of 68-Ga-labeled Octreotide Analogues PET in Diagnosis and Staging of Duodenal-pancreatic Neuroendocrine Tumours; Proposal of a Multicenter, Prospective Clinical Trial
The diagnostic work-up of patients suspected of having neuroendocrine tumours (NETs) has
traditionally been a challenging issue. The last two decades have been marked by the
application to use in the diagnosis of NETs of 3 newly available diagnostic techniques:
endoscopic ultrasonography (EUS), multidetector CT (MDCT), and more recently, positron
emission tomography using 68Ga-labelled octreotide analogues (PET). In a prospective study
conducted at a single referral centre that compared PET with conventional somatostatin
receptor scintigraphy and MDCT in diagnosis, staging and follow-up of patients affected by
NET, PET detected more primary and secondary lesions than other methods. Recent studies
investigated the clinical impact of PET in the management of patients affected by NET,
previously studied by MDCT. The investigators recently reported the results of the
investigation of 19 patients suspected of having primary pancreatic NET and studied by PET,
MDCT and EUS. The investigators preliminary data suggest that PET may be slightly more
sensitive than MDCT in detecting small (<2cm) pancreatic lesions; accuracy of PET and EUS is
probably similar. No prospective study has yet been devoted to evaluate the accuracy of PET
in the diagnosis and staging of primary duodenal-pancreatic NETs. Furthermore, the clinical
impact of the adjunct of PET to the traditional protocols of diagnosis and staging of these
tumours waits to be thoroughly evaluated. Thus the appropriate place of PET in the diagnostic
algorithm of patients suspected of having duodenal-pancreatic NET remains undefined.
The main aim of this project is to prospectively compare the accuracy of PET and MDCT in the
diagnosis and staging of patients suspected of having duodenal-pancreatic NETs. The
investigators hypothesised that PET is superior to MDCT in the diagnosis of these neoplasm
(the dimension of the study sample is estimated in order to detect a 10% difference). The
impact of PET on management plan of affected patients will also be evaluated. As a secondary
endpoint of the study, the investigators will compare EUS, PET and MDCT in the diagnosis of
primary duodenal-pancreatic NET. The study is designed as a multicentre, prospective,
non-randomised clinical trial. All patients will undergo MDCT, PET and EUS in this fixed
order.
n/a
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