Targets for Molecular Imaging of Neuroendocrine Tumors (NETs): An Overview and Update

Neuroendocrine neoplasms (NENs) represent a diverse group of tumors originating from neuroendocrine cells, characterized by their unique biological behavior and clinical manifestations. The incidence of neuroendocrine tumors (NETs) has been rising, necessitating effective diagnostic and therapeutic strategies. Molecular imaging, particularly through techniques such as PET and SPECT, plays a pivotal role in the management of NETs. This review highlights the significance of somatostatin receptor imaging in the initial diagnostic work-up, staging, and treatment planning for NETs, emphasizing the utility of radiopharmaceuticals like [⁶⁸Ga]Ga-DOTATATE and [⁶⁸Ga]Ga-DOTA-LM3. These agents demonstrate high sensitivity and specificity, allowing for accurate delineation of disease extent and identification of occult primary tumors. Furthermore, the review discusses the emerging role of nonsomatostatin receptor targets, such as glucose metabolism and fibroblast activation protein, in enhancing the diagnostic capabilities of molecular imaging. The integration of advanced imaging modalities, including dual-tracer approaches, is explored for their potential to refine therapeutic strategies and improve patient outcomes. As the field of molecular imaging continues to evolve, ongoing research and clinical trials are essential to validate the efficacy and safety of novel imaging agents and techniques, ultimately enhancing the management of patients with neuroendocrine tumors.