Advances in the Diagnosis of Neuroendocrine Neoplasms.

Abstract

Somatostatin receptor PET/CT using (68)Ga-labeled somatostatin analogs, is a mainstay for the evaluation of the somatostatin receptor status in neuroendocrine neoplasms. In addition, the assessment of glucose metabolism by (18)F-FDG PET/CT at diagnosis can overcome probable shortcomings of histopathologic grading. This offers a systematic theranostic approach for the management of neuroendocrine neoplasms, that is, patient selection for the appropriate treatment-surgery, somatostatin analogs, peptide receptor radionuclide therapy, targeted therapies like everolimus and sunitinib, or chemotherapy-and also for therapy response monitoring. Novel targets, for example, the chemokine receptor CXCR4 in higher-grade tumors and glucagon like peptide-1 receptor in insulinomas, appear promising for imaging. Scandium-44 and Copper-64, especially on account of their longer half-life (for pretherapeutic dosimetry) and cyclotron production (which favors mass production), might be the potential alternatives to (68)Ga for PET/CT imaging. The future of molecular imaging lies in Radiomics, that is, qualitative and quantitative characterization of tumor phenotypes in correlation with tumor genomics and proteomics, for a personalized cancer management.

• Authors: Harshad R Kulkarni, Aviral Singh, Richard P Baum
• Journal: Seminars in nuclear medicine (Semin Nucl Med) Vol. 46 Issue 5 Pg. 395-404 (09 2016) ISSN: 1558-4623 [Electronic] United States
• PMID: 27553465 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Chemical References

• Receptors, Somatostatin

Topics

• Humans
• Neuroendocrine Tumors (diagnosis, diagnostic imaging, metabolism)
• Positron Emission Tomography Computed Tomography
• Receptors, Somatostatin (metabolism)