Molecular Imaging of Gastroenteropancreatic Neuroendocrine Tumors: Current Status and Future Directions.
Fiche publication
Date publication
décembre 2016
Journal
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
Auteurs
Membres identifiés du Cancéropôle Est :
Pr IMPERIALE Alessio
Tous les auteurs :
Deroose CM, Hindié E, Kebebew E, Goichot B, Pacak K, Taïeb D, Imperiale A
Lien Pubmed
Résumé
Through diagnostic imaging and peptide receptor radionuclide therapy, nuclear medicine has earned a major role in gastroenteropancreatic neuroendocrine tumors (GEP NETs). GEP NETs are diagnosed fortuitously or on the basis of symptoms or hormonal syndrome. The functional tumor characteristics shown by radionuclide imaging allow for more accurate staging and treatment selection. Tumor grade helps determine which tracer should be selected. In the past, In-pentetreotide has been successful in well-differentiated (G1 and G2) tumors. However, PET/CT imaging with novel somatostatin analogs (e.g., Ga-DOTATOC, Ga-DOTATATE, Ga-DOTANOC, and Cu-DOTATATE) now offers improved sensitivity. F-fluorodihydroxyphenylalanine (F-FDOPA) is another interesting radiopharmaceutical. F-FDOPA sensitivity is influenced by a tumor's capacity to take up, decarboxylate, and store amine precursors. F-FDOPA sensitivities are highest in ileal NETs and may also be helpful in insulinomas. A high uptake of F-FDG with a low uptake of somatostatin analog usually indicates poorly differentiated tumors (G3). Starting from these principles, this article discusses theranostic approaches to GEP NETs, taking into account both primary and metastatic lesions.
Mots clés
Humans, Intestinal Neoplasms, diagnostic imaging, Molecular Imaging, methods, Neuroendocrine Tumors, diagnostic imaging, Pancreatic Neoplasms, diagnostic imaging, Precision Medicine, Stomach Neoplasms, diagnostic imaging
Référence
J. Nucl. Med.. 2016 Dec;57(12):1949-1956