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Open Access Case report

Blood transcript analysis and metastatic recurrent small bowel carcinoid management

Irvin M Modlin1*, Ignat Drozdov2, Lisa Bodei3 and Mark Kidd4

Author Affiliations

1 Wren Laboratories, 35 NE Industrial Road, Branford, CT 06405, USA

2 Bering Limited, Richmond, UK

3 Division of Nuclear Medicine, European Institute of Oncology, Milan, Italy

4 Department of Surgery, Yale University School of Medicine, New Haven, CT 06510, USA

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BMC Cancer 2014, 14:564  doi:10.1186/1471-2407-14-564

Published: 5 August 2014



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 68Ga-DOTA-PET/CT in a patient with NET.


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.

Biomarker; Blood; Carcinoid; Chromogranin A; 68Gallium; Gene marker; Neuroendocrine tumor; PCR; PET/CT