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Related Experiment Video

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Comparing Response Evaluation Methods for PRRT in Neuroendocrine Tumors: Insights from an Exploratory Study.

Priscilla Guglielmo1,2, Carlo Carnaghi3, Alexia Francesca Bertuzzi4

  • 1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy.

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|May 4, 2026
PubMed
Summary

Assessing neuroendocrine tumor (NET) treatment response after peptide receptor radionuclide therapy (PRRT) is challenging. Functional imaging shows a trend toward better progression-free survival correlation than RECIST or Krenning scores, but findings are hypothesis-generating.

Keywords:
NETPRRTneuroendocrine tumorsradioligand therapyresponse evaluation

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Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiology

Background:

  • Assessing treatment response in neuroendocrine tumors (NETs) is complex, especially after peptide receptor radionuclide therapy (PRRT) due to its multifactorial mechanism and lack of standardized criteria.
  • Accurate response evaluation is crucial for guiding further treatment and predicting patient outcomes.

Purpose of the Study:

  • To compare various imaging-based response assessment methods following PRRT in NET patients.
  • To explore the relationship between these assessment methods and clinical outcomes, specifically progression-free survival (PFS).

Main Methods:

  • Retrospective analysis of 31 NET patients treated with PRRT, who underwent [68Ga]Ga-DOTATOC PET/CT before and after therapy.
  • Evaluation of five response criteria: Krenning Score, adapted PERCIST (MORE), ZP-normalized parameter, qualitative visual PET assessment, and RECIST-based CT response.
  • Correlation of imaging findings with clinical outcomes using nonparametric analyses.

Main Results:

  • Response rates varied significantly across methods: functional imaging (MORE 66%, Visual PET 68%, ZP 70%) showed higher rates than RECIST (40%) and Krenning score (21%).
  • After a median follow-up of 37 months, 58% of patients progressed.
  • No statistically significant association was found between response criteria and progression, though functional imaging demonstrated a trend towards better correlation with longer PFS.

Conclusions:

  • Functional PET-based response criteria may correlate with progression-free survival in NET patients treated with PRRT, potentially outperforming RECIST and Krenning scores.
  • These findings are exploratory and hypothesis-generating due to study limitations, and do not provide definitive evidence for practice change.