Gastroenteropancreatic neuroendocrine tumours (GEP-NET) - Imaging and staging

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• Morphological imaging (CT, MRI) is standard for gastroenteropancreatic neuroendocrine tumour (GEP-NET) detection and treatment monitoring.
• Molecular imaging, especially hybrid imaging (PET/CT), enhances patient management through improved tumor localization and staging.
• Somatostatin receptor scintigraphy (SRS) and somatostatin receptor (SSTR) positron emission tomography (PET) are crucial for diagnosing well-differentiated GEP-NETs.

Purpose of the Study:

• To evaluate the role and limitations of current molecular imaging techniques in GEP-NET diagnosis.
• To compare the efficacy of SSTR PET/CT with SRS and other PET tracers.
• To highlight emerging innovations for improved GEP-NET imaging.

Main Methods:

• Review of current literature on molecular imaging for GEP-NETs.
• Comparison of SSTR PET/CT, SRS, (18)F-DOPA PET/CT, and (18)F-FDG PET/CT.
• Discussion of limitations and potential of novel imaging agents and techniques.

Main Results:

• SSTR PET/CT is superior to SRS for well-differentiated GEP-NETs and should be prioritized.
• (18)F-DOPA and (18)F-FDG PET/CT are less effective than SSTR PET/CT in well-differentiated GEP-NETs.
• SSTR PET/CT and SRS show limitations in detecting benign insulinomas, poorly differentiated GEP-NETs, and liver metastases.

Conclusions:

• SSTR PET/CT is the leading molecular imaging modality for GEP-NETs, offering advantages over SRS.
• Current techniques have limitations, necessitating further research and development.
• Emerging technologies like SSTR PET/MRI and GLP-1R agonists hold potential for advancing GEP-NET imaging.