[Detection of bone metastases in patients with neuroendocrine gastrointestinal tumors].

INTRODUCTION: In patients with neuroendocrine gastrointestinal tumors and liver metastases, but without known extrahepatic manifestations, liver transplantation may be indicated as curativ or "long-term-palliativ" therapy. For these patients the absence of bone lesions is mandatory.

METHODS: 4 patients with a histologically proven neuroendocrine tumor were examined in order to exclude further metastases. We compared the diagnostic value of somatostatin-receptor-scintigraphy (SRS), X-ray, 99mTc-DPD-scintigraphy, CT and MRI.

RESULTS: In all 4 patients bone metastases could be detected using SRS, CT und MRT. In one case MRI proved multiple infiltrations, while SRS showed only a solitary, focal lesion. 99mTc-DPD-scintigraphy was positive in 3 cases, X-ray in 1 case.

CONCLUSION: As a diagnostic strategy we initially recommend somatostatin-receptor-scintigraphy. When locating suspect areas in SRS, MRI should be the method of choice for the exact evaluation of malignant bone infiltrations. A CT-guided biopsy is necessary to gain histological information.