Abstract
Gastro-entero-pancreatic neuroendocrine neoplasia (GEP-NENs) are rare tumors, but their frequency is increasing. Neuroendocrine tumors normally express somatostatin (SST) receptors (SSTR) on cell surface, especially G1 and G2 stage tumors, but they can show a dedifferentiation in their clinical history as they become more aggressive. Somatostatin receptor imaging has previously been performed with a gamma camera using [111In]In or [99mTc]Tc-labelled compounds, while [68Ga]Ga-labelled compounds and PET/CT imaging has recently become the gold standard for the diagnosis and management of these tumors. Moreover, in the last few years 18F-fluorodeoxyglucose ([18F]FDG) PET/CT has emerged as an important tool to define tumor aggressiveness and give relevant prognostic information, particularly when coupled with [68Ga]Ga-labelled SST analogues PET/CT. This review focuses on the importance of combined imaging with [68Ga]Ga-labelled SST analogues and [18F]FDG for the management of GEP-NENs.
Highlights
Gastro-entero-pancreatic neuroendocrine neoplasia (GEP-NENs) or neuroendocrine tumors (NET) are rare and heterogeneous diseases, with increasing incidence and prevalence over the last decades [1]
Hybrid positron emission tomography and computed tomography with 68Ga-labelled SST analogues ([68Ga]Ga-DOTA-SST PET/CT) is considered the gold standard technique in GEP-NENs, due to its high sensitivity and specificity, which are reported to vary between 91–95% and 82–97%, respectively [6]
Positron emission tomography/computed tomography with 18F-fluorodeoxyglucose ([18F]FDG PET/CT) has been suggested as an alternative tool for tissue sampling for the assessment of the aggressiveness of tumors, and it has shown prognostic value in NENs [7]
Summary
Gastro-entero-pancreatic neuroendocrine neoplasia (GEP-NENs) or neuroendocrine tumors (NET) are rare and heterogeneous diseases, with increasing incidence and prevalence over the last decades [1]. Their prognosis is affected by a number of factors, including the primary tumor site, grading and staging [2,3,4]. Hybrid positron emission tomography and computed tomography with 68Ga-labelled SST analogues ([68Ga]Ga-DOTA-SST PET/CT) is considered the gold standard technique in GEP-NENs, due to its high sensitivity and specificity, which are reported to vary between 91–95% and 82–97%, respectively [6]. The role of [68Ga]Ga-DOTA-SST PET/CT and [18F]FDG PET/CT in NENs was investigated, focusing on the impact of their combined use in the clinical practice
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