Abstract B34: Diagnostics of pancreatic duct hypertension by the serotonin-stimulated magnetic resonance cholangiopancreatography

Abstract

Abstract Background: Serotonin is a neurotransmitter and humoral enhancer which stimulates the pancreatic secretion. Unlike secretin serotonin doesn’t change the proteinogramm of pancreatic juice1. Pancreatic and periampullary tumors can cause the dilatation of the main pancreatic duct. Its partial stenosis can remain undiagnosed on conventional MRCP. Increasing secretion of pancreatic juice after serotonin stimulation can improve the diagnosis, particularly the location and length of a lesion. Method: Eighteen patients with pancreatic cancer (n=14) and tumor of papilla Vateri (n=4) were included into the study. Median age was 64.9 years with range 45-84 years. Serotonin (0,01mg/kg) was administered perorally (n=2), intramuscularly (n=2), or intravenously with dilution (n=5) and without it (n=9). MRCP was performed before the drug application and 7 minutes after that. Results: In cases where serotonin was administered perorally, intramuscularly or intravenously with dilution we have not received any significant results (Tab. 1). The positive results were obtained in 5 (55.6%) of 9 cases when MRCP was performed 7 minutes after intravenous administration of concentrated solution. The mean increase in width of the main pancreatic duct was 1.1 mm (range 0.9-1.9 mm). Conclusion: The method of serotonin-stimulated MRCP can improve the diagnosis of pancreatic ductal hypertension. In these 5 cases the presented technique allowed us to detect the size and localization of a lesion more precisely: tumor of a papilla (n=2), cancer of a pancreatic head (n=3) including one case with involvement of the pancreatic body. In cases of primary ductal dilatation more than 5 mm (n=3) we have not received any positive results, so these patients were excluded from the study. Note: This abstract was not presented at the conference. Citation Format: Alexey Kashintsev, Konstantin Pavelets, Nikolai Kokhanenko, Evgeny Imyanitov. Diagnostics of pancreatic duct hypertension by the serotonin-stimulated magnetic resonance cholangiopancreatography. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Innovations in Research and Treatment; May 18-21, 2014; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2015;75(13 Suppl):Abstract nr B34.