Related Experiment Video
Updated: May 5, 2026
Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
Neuroendocrine tumours: the role of imaging for diagnosis and therapy
Martijn van Essen1, Anders Sundin2, Eric P Krenning1
1Department of Nuclear Medicine, Erasmus MC, 's Gravendijkwal 230, Rotterdam, 3015 GD, Netherlands.
Abstract:
In patients with neuroendocrine tumours (NETs), a combination of morphological imaging and nuclear medicine techniques is mandatory for primary tumour visualization, staging and evaluation of somatostatin receptor status. CT and MRI are well-suited for discerning small lesions that might escape detection by single photon emission tomography (SPECT) or PET, as well as for assessing the local invasiveness of the tumour or the response to therapy. Somatostatin receptor imaging, by (111)In-pentetreotide scintigraphy or PET with (68)Ga-labelled somatostatin analogues, frequently identifies additional lesions that are not visible on CT or MRI scans. Currently, somatostatin receptor scintigraphy with (111)In-pentetreotide is the more frequently available of the two techniques to determine somatostatin receptor expression and is needed to select patients for peptide receptor radionuclide therapy. In the future, because of its higher sensitivity, PET with (68)Ga-labelled somatostatin analogues is expected to replace somatostatin receptor scintigraphy. Whereas (18)F-FDG-PET is only used in high-grade neuroendocrine cancers, PET-CT with (18)F-dihydroxy-L-phenylalanine or (11)C-5-hydroxy-L-tryptophan is a useful problem-solving tool and could be considered for the evaluation of therapy response in the future. This article reviews the role of imaging for the diagnosis and management of intestinal and pancreatic NETs. Response evaluation and controversies in NET imaging will also be discussed.
Insights
Advanced imaging techniques like CT, MRI, and nuclear medicine are crucial for diagnosing neuroendocrine tumors (NETs). Somatostatin receptor imaging, particularly PET with (68)Ga-labelled analogues, offers superior sensitivity for lesion detection and staging.
Area of Science:
- Radiology and Nuclear Medicine
- Oncology
- Medical Imaging
Background:
- Accurate diagnosis and staging of neuroendocrine tumors (NETs) require integrated morphological and nuclear medicine imaging.
- CT and MRI excel at visualizing small lesions and assessing tumor invasiveness and treatment response.
- Nuclear medicine, including somatostatin receptor imaging, detects additional lesions missed by CT/MRI.
Purpose of the Study:
- To review the current role of various imaging modalities in the diagnosis and management of intestinal and pancreatic NETs.
- To discuss the application of different imaging techniques for staging, somatostatin receptor evaluation, and therapy response assessment.
- To highlight the evolving landscape of NET imaging, including the future potential of PET-based methods.
Main Methods:
- Review of morphological imaging (CT, MRI) for lesion detection and local assessment.
- Analysis of nuclear medicine techniques: somatostatin receptor scintigraphy ((111)In-pentetreotide) and PET ((68)Ga-labelled analogues).
- Discussion of PET-CT with (18)F-FDG, (18)F-dihydroxy-L-phenylalanine, and (11)C-5-hydroxy-L-tryptophan for specific NET subtypes and problem-solving.
Main Results:
- Combination imaging is mandatory for NET visualization, staging, and somatostatin receptor status.
- (111)In-pentetreotide scintigraphy is currently standard for receptor expression and therapy selection.
- PET with (68)Ga-labelled analogues shows higher sensitivity and is expected to supersede scintigraphy.
- (18)F-FDG-PET is limited to high-grade NETs; other PET tracers are useful for problem-solving and potential therapy response evaluation.
Conclusions:
- Integrated imaging combining CT/MRI with nuclear medicine is essential for comprehensive NET management.
- Somatostatin receptor imaging is vital for patient selection for peptide receptor radionuclide therapy.
- Future NET imaging will likely rely on higher-sensitivity PET techniques for improved diagnosis and monitoring.
More Related Videos
Related Concept Videos
01:25Imaging Studies II: Positron Emission Tomography and Scintigraphy
Fundamental Principles of PET
01:14Brain Imaging
These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans), magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), and Transcranial Magnetic...