Abstract
THERANOSTICS is an acronym that exemplifies the inseparability of diagnostics and therapeutics in the individualized management of disease. Neuroendocrine tumors (NETs) express somatostatin receptors (SSTRs), enabling the use of somatostatin (SMS) analogs for molecular imaging, when labeled with the positron emitter gallium- 68 (68Ga) for receptor positron emission tomography computed tomography (PET/CT) and targeted radionuclide therapy when labeled with beta-emitters 90Y and 177Lu (Fig. 1). Peptide receptor radionuclide therapy (PRRT) using 90Y- and 177Lu-labeled SMS analogs or a combination of the two (DUO-PRRT) is highly effective in the management of advanced or progressive NETs. Apart from benefit in overall survival from time of diagnosis of several years, significant improvement in clinical symptoms and excellent palliation can be achieved. In patients with progressive NETs, fractionated, personalized PRRT with lower doses of radioactivity given over a longer period of time results in good therapeutic responses.
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