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Previous Volume 331:1116-1121 October 27, 1994 Number 17 Next

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ABSTRACT

Background Intestinal adenocarcinomas and various endocrine tumors express large numbers of high-affinity receptors for vasoactive intestinal peptide (VIP). We have evaluated the usefulness of scanning with VIP labeled with iodine-123 for tumor localization in patients with gastrointestinal tumors.

Methods Radioiodinated VIP was purified by high-pressure liquid chromatography and administered as a single intravenous bolus injection (300 pmol [1 microg]). Scanning with radiolabeled VIP was compared with computed tomography and scanning with somatostatin analogues in 79 patients with colorectal cancer, pancreatic carcinoma, gastric cancer, carcinoid tumor, or insulinoma.

Results Visualization of gastrointestinal tumors and metastases was obtained with radiolabeled VIP. Binding of the labeled peptide by primary tumors and metastases was visible shortly after the injection and was still demonstrable at 24 hours. In patients with colorectal adenocarcinomas, primary or recurrent tumors were visualized in 10 of 10, liver metastases in 15 of 1, lung metastases in 2 of 3, and lymph-node metastases in 4 of 4. Primary pancreatic adenocarcinomas were visualized by imaging in 10 of 12 patients, and liver metastases were seen in 7 of 7. Primary or recurrent gastric adenocarcinomas were visualized in five of five patients, and liver metastases were seen in two of two patients. VIP scans were positive in 9 of 10 patients with carcinoid tumors and in 4 of 4 patients with insulinomas. Some tumors with positive VIP scans were also visualized with somatostatin analogues (4 of 17 colorectal adenocarcinomas, 8 of 9 carcinoids, and 2 of 2 insulinomas). In vitro binding studies confirmed the presence of VIP receptors on gastrointestinal tumors.

Conclusions Scanning with radiolabeled VIP can visualize intestinal tumors and metastases that express receptors for VIP.

Source Information

From the Departments of Nuclear Medicine (I.V., A.K., S.B., Q.Y., S.L., M.B.), Clinical Pharmacology (I.V.), and Surgery (B.N.); the Divisions of Oncology (M.R., W.S.) and Hematology (P.V.); Internal Medicine I; and the Division of Gastroenterology, Internal Medicine IV (J.P.), the University of Vienna, Vienna; and the Department of Radiochemistry, Research Center, Seibersdorf (P.A.) -- both in Austria.

Address reprint requests to Dr. Virgolini at the Department of Nuclear Medicine, University of Vienna, Wahringer Gurtel 18-20, Ebene 3L, A-1090 Vienna, Austria.

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