effect of octreotide LAR ( 4 , 6 , 9 ). In most of these studies, the liver tumour burden was evaluated by a visual semi-quantitative assessment of the total tumour volume in the liver on CT scan and/or MRI, categorised into three to five classes by
Magaly Zappa, Olivia Hentic, Marie-Pierre Vullierme, Matthieu Lagadec, Maxime Ronot, Philippe Ruszniewski and Valérie Vilgrain
Milène Tetsi Nomigni, Sophie Ouzounian, Alice Benoit, Jacqueline Vadrot, Frédérique Tissier, Sylvie Renouf, Hervé Lefebvre, Sophie Christin-Maitre and Estelle Louiset
clinical signs of hypercorticism. In the follow-up of her kidney atrophy, a computerized tomography (CT)-scan revealed the presence of a right adrenal lesion measuring 26 mm. Venous blood sampling from right and left adrenals, ovaries and periphery were
Thabiso R P Mofokeng, Salem A Beshyah, Fazleh Mahomed, Kwazi C Z Ndlovu and Ian L Ross
.2–46.0) <0.001 Sometimes/often unavailable 131 (55.7) 24 (53.3) 155 (55.3, 49.3–61.3) 0.212 Adrenal CT scan Never unavailable 99 (42.5) 29 (65.9) 0.017 128 (46.2, 40.2–52.3) 0.494 Sometimes/often unavailable
Lars Peter Sørensen, Tina Parkner, Esben Søndergaard, Bo Martin Bibby, Holger Jon Møller and Søren Nielsen
blood samples were drawn for screening purposes. One week before the study day, included participants visited again. Dual X-ray absorptiometry (DXA) scan and abdominal CT scan were performed to determine body composition and regional fat distribution
Gamze Akkuş, Isa Burak Güney, Fesih Ok, Mehtap Evran, Volkan Izol, Şeyda Erdoğan, Yıldırım Bayazıt, Murat Sert and Tamer Tetiker
prevalence of adrenal incidentalomas detected by abdominal CT scan varies between 2.5 and 4% in adult populations. The management of adrenal incidentalomas depends on the lesion’s being benign or malignant and any adrenal hormone secretion related with the
Kjell Oberg, Eric Krenning, Anders Sundin, Lisa Bodei, Mark Kidd, Margot Tesselaar, Valentina Ambrosini, Richard P Baum, Matthew Kulke, Marianne Pavel, Jaroslaw Cwikla, Ignat Drozdov, Massimo Falconi, Nicola Fazio, Andrea Frilling, Robert Jensen, Klaus Koopmans, Tiny Korse, Dik Kwekkeboom, Helmut Maecke, Giovanni Paganelli, Ramon Salazar, Stefano Severi, Jonathan Strosberg, Vikas Prasad, Aldo Scarpa, Ashley Grossman, Annemeik Walenkamp, Mauro Cives, Irene Virgolini, Andreas Kjaer and Irvin M Modlin
The complexity of the clinical management of neuroendocrine neoplasia (NEN) is exacerbated by limitations in imaging modalities and a paucity of clinically useful biomarkers. Limitations in currently available imaging modalities reflect difficulties in measuring an intrinsically indolent disease, resolution inadequacies and inter-/intra-facility device variability and that RECIST (Response Evaluation Criteria in Solid Tumors) criteria are not optimal for NEN. Limitations of currently used biomarkers are that they are secretory biomarkers (chromogranin A, serotonin, neuron-specific enolase and pancreastatin); monoanalyte measurements; and lack sensitivity, specificity and predictive capacity. None of them meet the NIH metrics for clinical usage. A multinational, multidisciplinary Delphi consensus meeting of NEN experts (n = 33) assessed current imaging strategies and biomarkers in NEN management. Consensus (>75%) was achieved for 78% of the 142 questions. The panel concluded that morphological imaging has a diagnostic value. However, both imaging and current single-analyte biomarkers exhibit substantial limitations in measuring the disease status and predicting the therapeutic efficacy. RECIST remains suboptimal as a metric. A critical unmet need is the development of a clinico-biological tool to provide enhanced information regarding precise disease status and treatment response. The group considered that circulating RNA was better than current general NEN biomarkers and preliminary clinical data were considered promising. It was resolved that circulating multianalyte mRNA (NETest) had clinical utility in both diagnosis and monitoring disease status and therapeutic efficacy. Overall, it was concluded that a combination of tumor spatial and functional imaging with circulating transcripts (mRNA) would represent the future strategy for real-time monitoring of disease progress and therapeutic efficacy.
Christian Høst, Anders Bojesen, Mogens Erlandsen, Kristian A Groth, Kurt Kristensen, Anne Grethe Jurik, Niels H Birkebæk and Claus H Gravholt
Context and objective
Males with Klinefelter syndrome (KS) are typically hypogonadal with a high incidence of metabolic disease, increased body fat and mortality. Testosterone treatment of hypogonadal patients decrease fat mass, increase lean body mass and improve insulin sensitivity, but whether this extends to patients with KS is presently unknown.
Research design and methods
In a randomized, double-blind, placebo-controlled, BMI-matched cross-over study, 13 males with KS (age: 34.8 years; BMI: 26.7 kg/m2) received testosterone (Andriol®) 160 mg per day (testosterone) or placebo treatment for 6 months. Thirteen age- and BMI-matched healthy controls were recruited. DEXA scan, abdominal computed tomography (CT) scan and a hyperinsulinemic–euglycemic clamp, muscle strength and maximal oxygen uptake measurement were performed.
Total lean body mass and body fat mass were comparable between testosterone-naïve KS and controls using DEXA, whereas visceral fat mass, total abdominal and intra-abdominal fat by CT was increased (P < 0.05). Testosterone decreased total body fat (P = 0.01) and abdominal fat by CT (P = 0.04). Glucose disposal was similar between testosterone-naïve KS and controls (P = 0.3) and unchanged during testosterone (P = 0.8). Free fatty acid suppression during the clamp was impaired in KS and maximal oxygen uptake was markedly lower in KS, but both were unaffected by treatment. Testosterone increased hemoglobin and IGF-I.
Testosterone treatment in adult males with KS for 6 months leads to favorable changes in body composition with reductions in fat mass, including abdominal fat mass, but does not change measures of glucose homeostasis.
Majunath R Goroshi, Swati S Jadhav, Anurag R Lila, Rajeev Kasaliwal, Shruti Khare, Chaitanya G Yerawar, Priya Hira, Uday Phadke, Hina Shah, Vikram R Lele, Gaurav Malhotra, Tushar Bandgar and Nalini S Shah
-photon emission computed tomography (SPECT)-based octreotide scintigraphy ( 123 I-Tyr-3-octreotide and 111 In-DTPA-pentetreotide) and more recently PET-based imaging such as 18 F-FDG PET/CT scan and 68 Ga-based somatostatin receptor (SSTR) positron emission
Qiuli Liu, Gang Yuan, Dali Tong, Gaolei Liu, Yuting Yi, Jun Zhang, Yao Zhang, Lin-ang Wang, Luofu Wang, Dianzheng Zhang, Rongrong Chen, Yanfang Guan, Xin Yi, Weihua Lan and Jun Jiang
May 2015 due to masses in her right kidney and left adrenal gland. The CT scan showed a mass of 2.5 × 2.1 cm and multiple cysts in her right kidney ( Fig. 1A , upper image), and a mass of 6.1 × 3.9 cm in her left adrenal gland ( Fig. 1A , middle image
Norra Kwong, Ellen Marqusee, Michael S Gordon, P Reed Larsen, Jeffrey R Garber, Matthew I Kim and Erik K Alexander
lung fields or bony structures. During follow-up, thyroglobulin was persistently detectable with concentrations of ∼19 ng/ml. A CT scan revealed bilateral pulmonary nodules ranging from 2 to 5 mm in diameter. No further treatment was provided at that