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Nuclear medicine in NET

Nuklearmedizinische Diagnostik bei Patienten mit neuroendokrinen Tumoren

Wiener Medizinische Wochenschrift volume 162, pages 416–422 (2012)Cite this article

Summary

Neuroendocrine tumors (NET) are, despite increasing incidence, still rare, usually slow growing neoplasms with resemblance to nerve cells and the endocrine capability of hormone production. In contrast to commonly used conventional imaging procedures, nuclear imaging is feasible to visualize the presence of molecular biomarkers, particularly the overexpression of somatostatin receptors (sstr) with high diagnostic accuracy which has led to the establishment of somatostatin receptor scintigraphy (SRS) as essential component and gold standard of functional imaging in the workup of NET. Another major feature is the selection of patients with inoperable or metastasized tumors showing sufficient uptake for peptide receptor radionuclide therapy (PRRT). While somatostatin receptor PET and PET/CT using Ga-68-labeled SSR analogs represents the consistent further development of SRS, FDG-PET can only be used in tumors with high proliferative activity but not on a routine basis for imaging of neuroendocrine tumors. 18F-DOPA represents an alternative PET tracer worth mentioning currently under assessment for NET imaging.

Zusammenfassung

Neuroendokrine Tumoren (NET) stellen trotz steigender Inzidenz eine Gruppe seltener, gewöhnlich langsam wachsender Neoplasien mit Beziehung zu neuralen Zellen sowie der typisch endokrinen Fähigkeit zur Hormonproduktion dar. Im Gegensatz zu konventionellen bildgebenden Verfahren bietet die molekulare Bildgebung die Möglichkeit der Darstellung vorhandener molekularer Biomaker, im Speziellen die für NET typische verstärkte Expression von Somatostatinrezeptoren (sstr) mit hoher diagnostischer Treffsicherheit, was zur Etablierung der Somatostatinrezeptorszintigraphie (SRS) als essentieller Bestandteil und Goldstandard der funktionellen Bildgebung im Rahmen der NET Diagnostik geführt hat. Weiteres wichtiges Merkmal der Methode ist die Selektion von Patienten mit fortgeschrittener Erkrankung und ausreichendem Uptake für die Peptidrezeptor-Radionuklidtherapie (PRRT). Während Somatostatinrezeptor-PET und PET/CT mit Ga-68 markierten SSR-Analoga die logische Weiterentwicklung der SRS darstellt, kann die FDG-PET lediglich bei NET mit hoher proliferativer Aktivität eingesetzt werden und stellt keine Standardbildgebung von neuroendokrinen Tumoren dar. 18F-DOPA steht als alternativer PET-Tracer zur Evaluierung von NET für diverse Tumorentitäten zur Verfügung.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Endocrinology, PET-CT Center Klagenfurt, Feschnigstraße 11, 9020, Klagenfurt, Austria

    Manfred Sorschag MD

  2. Abteilung für Nuklearmedizin und spezielle Endokrinologie, PET/CT Zentrum Klagenfurt, Klinikum Klagenfurt am Wörthersee, Feschnigstraße 11, 9020, Klagenfurt, Austria

    Phillip Malle & Hans-Jürgen Gallowitsch

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  1. Manfred Sorschag MD
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Correspondence to Manfred Sorschag MD.

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Sorschag, M., Malle, P. & Gallowitsch, HJ. Nuclear medicine in NET. Wien Med Wochenschr 162, 416–422 (2012). https://doi.org/10.1007/s10354-012-0130-z

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Keywords

  • NET
  • Neuroendocrine tumors
  • Nuclear imaging
  • Somatostatin receptor scintigraphy
  • Peptide imaging
  • 68Ga-DOTATOC PET/CT

Schlüsselwörter

  • NET
  • Neuroendokrine Tumoren
  • Molekulare Bildgebung
  • Somatostatinrezeptorszintigraphie
  • Somatinrezeptor-PET/CT
  • 6 8Ga-DOTATOC PET/CT