Blood transcript analysis and metastatic recurrent small bowel carcinoid management

Irvin M Modlin, Ignat Drozdov, Lisa Bodei, Mark Kidd, Irvin M Modlin, Ignat Drozdov, Lisa Bodei, Mark Kidd

Abstract

Background: Detection of neuroendocrine tumor (NET) disease progression is a key issue in determining management. Currently, assessment is by imaging (MRI/CT and Octreoscan®) and plasma Chromogranin A (CgA) measurement.

Case presentation: We report use of a NET-specific multigene PCR-derived blood transcript signature (NET Index) to assess disease and correlated CgA and gene transcripts with MRI, CT, Octreoscan®, 11C-5HTP-PET/CT and (68)Ga-DOTA-PET/CT in a patient with NET.

Conclusions: Our results identify limitations in evaluating disease status by CgA and identify that a PCR-based test is more sensitive. Alteration in NET blood gene transcript levels prior to image-based tumor confirmation suggests this parameter may also have utility as an index of therapeutic efficacy.

Figures

Figure 1
Figure 1
Distinctive appearance at11C-HTP and68Ga-SST PET/CT of the liver (A and D) and bone metastases (B and E); no other lesions were detected at control PET scan performed with68Ga-SST (C).
Figure 2
Figure 2
Time line correlating plasma CgA measurements (DAKO ELISA, U/L) and the NET Index (%) (both y-axis) with the imaging and interventions (x-axis).

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Pre-publication history
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