How do you approach rising gastrin and chromogranin levels without radiographic evidence of disease in patients with gastrinoma that has been fully resected?  

We see this scenario with some frequency - rising hormone or peptide levels in functional NETs without radiographic evidence of disease. My next step would be to get the new Ga68 DOTA TATE PET/CT - essentially a new generation octreoscan with high sensitivity and specificity.  These scans often...