PMC4921170_01
An In-111 pentetreotide octreotide scan showed an avid focus at the epigastrium (open arrow), besides physiologic uptake in the kidneys and the spleen.
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A further approach to investigating the etiology of the hypergastrinemia (an In-111 pentetreotide scan) showed an avid focus at the epigastrium (Fig. 1, open arrow), besides physiologic uptake in the kidneys and the spleen.
Pentetreotide imaging plus abdomen scintigrams. The patient was asked to drink a mouthful of water with Tc-99m pertechnetate added. Dual-isotope planar images were acquired simultaneously, centering on the In-111 photopeaks and on the Tc-99m photopeak. The Tc-99m abdomen images were displayed to be the background maps (A and B). The In-111 image was superimposed onto a Tc-99m image (C and D), which showed that the pathologic focus was next to the duodenum and inside the gastrinoma triangle.
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The Tc-99m abdomen images were displayed to be the background maps (Fig. 2, A & B). The In-111 image was superimposed onto a Tc-99m image (Fig. 2, C & D), which showed that the pathologic focus was next to the duodenum and inside the gastrinoma triangle.  Subsequent CT revealed a 2.7x2.4-cm, lobulated, enhancing lesion at the pancreas head (Fig. 3).
Abdomen CT axial (A) and coronal (B) images showing a 2.7x2.4-cm, lobulated, enhancing lesion at the pancreas head (open arrow).
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The Tc-99m abdomen images were displayed to be the background maps (Fig. 2, A & B). The In-111 image was superimposed onto a Tc-99m image (Fig. 2, C & D), which showed that the pathologic focus was next to the duodenum and inside the gastrinoma triangle.  Subsequent CT revealed a 2.7x2.4-cm, lobulated, enhancing lesion at the pancreas head (Fig. 3).