Imaging in Neuroendocrine Tumors: An Update for the Clinician

Maxwell, Jessica; Howe, James R.

doi:10.2217/ije.14.40

Cited by 110 publications

(80 citation statements)

References 49 publications

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“…The radionucleotides used in this test are indium-111 octreotide ( Figure 2) and indium-111 pentetreotide. Somatostatin receptor scintigraphy alone or in combination with other imaging modalities led to the detection of more tumor sites than any combination of imaging studies [33]. Echocardiography (TTE): TTE should be performed in all patients with carcinoid syndrome and a high suspicion for cardiac involvement consistent with clinical features such as cardiac murmurs, raised brain natriuretic peptide (BNP), or pro-b-type natriuretic peptide (proBNP) with or without thickening and retraction of immobile tricuspid valve leaflets and pulmonary valve cusps with associated tricuspid regurgitation [34].…”

Section: Laboratorymentioning

confidence: 99%

Carcinoid Syndrome: A Review

Gade¹,

Olariu²,

Douthit³

2020

Cureus

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Carcinoid syndrome (CS) is a paraneoplastic syndrome caused by the release of serotonin and other substances from well-differentiated neuroendocrine tumors (NETs). The hallmark symptoms of carcinoid syndrome are flushing and diarrhea; atypical signs and symptoms can include wheezing, abdominal pain, valvular heart disease, telangiectasias, pellagra, and the complications of mesenteric fibrosis, including ureteral obstruction, bowel obstruction, and bowel ischemia. These symptoms are mediated by the release of serotonin (5-HT), histamine, kallikrein, prostaglandins, and tachykinins. The diagnosis of CS requires these symptoms and corresponding elevations in lab tests. Treatment options include surgery and medical management with somatostatin analogs.

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Section: Laboratorymentioning

confidence: 99%

Carcinoid Syndrome: A Review

Gade¹,

Olariu²,

Douthit³

2020

Cureus

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“…Oneoft he most widespread and reliable noninvasive staging tools for cancer is PET/CT-namely, 18 F-FDG PET/CT for lung cancer (LC (1,2)) and malignant melanoma (MM (1,3)), 68 Ga-labeled prostate-specific membrane antigen (PSMA) PET/ CT for prostate cancer (PCA (4)), and 68 Ga-DOTATOC PET/ CT for gastroenteropancreatic neuroendocrine tumors (GEP NETs (5)). An exact evaluation of lymph node (LN) status before therapy is crucial to therapy planning.…”

mentioning

confidence: 99%

Correlation Between SUV_max and CT Radiomic Analysis Using Lymph Node Density in PET/CT-Based Lymph Node Staging

et al. 2016

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In patients with lung cancer (LC), malignant melanoma (MM), gastroenteropancreatic neuroendocrine tumors (GEP NETs), and prostate cancer (PCA), lymph node (LN) staging is often performed by 18 F-FDG PET/CT (LC and MM), 68 Ga-DOTATOC PET/CT (GEP NET), and 68 Ga-labeled prostate-specific membrane antigen PET/CT (PCA) but is sometimes not accurate because of indeterminate PET findings. To better evaluate malignant LN infiltration, additional surrogate parameters, especially in cases with indeterminate PET findings, would be helpful. The purpose of this study was to evaluate whether SUV max in the PET examination might correlate with semiautomated density measurements of LNs in the CT component of the PET/CT examination. Methods: After approval by the institutional review board, 1,022 LNs in the PET/CT examinations of 148 patients were retrospectively analyzed (LC: 327 LNs of 40 patients; MM: 224 LNs of 33 patients; GEP NET: 217 LNs of 35 patients; and PCA: 254 LNs of 40 patients). PET/CT was performed before surgery, biopsy, chemotherapy, or internal or external radiation therapy, according to the clinical schedule; patients with prior chemotherapy or radiation therapy were excluded. SUV max analyses were based on uptake 60 min after tracer injection, and volumetric CT histogram analyses were based on the unenhanced CT images of the PET/CT scan. Results: PET findings were considered positive or negative on the basis of SUV max in the LN compared with that in the blood pool; histologic confirmation was not available. Of the 1,022 LNs, 331 were PET-positive (3 times the SUV max of the blood pool), 86 were PET-indeterminate (1-3 times the SUV max of the blood pool), and 605 were PET-negative (less than the SUV max of the blood pool). PET-positive LNs had significantly higher CT densities than PET-negative LNs, irrespective of the type of cancer. Conclusion: CT density measurements of LNs in patients with LC, MM, GEP NET, and PCA correlated with 18 F-FDG uptake, 68 Ga-DOTATOC uptake, and 68 Ga-PSMA uptake, respectively, and might therefore serve as an additional surrogate parameter for differentiating between malignant and benign LNs. The use of a 7.5-Hounsfield unit CT density threshold to differentiate between malignant and benign LN infiltration and 20 Hounsfield units to exclude benign LN processes might be possible in clinical routine and would be especially helpful for PET-indeterminate LNs. Oneoft he most widespread and reliable noninvasive staging tools for cancer is PET/CT-namely, 18 F-FDG PET/CT for lung cancer (LC (1,2)) and malignant melanoma (MM (1,3)), 68 Ga-labeled prostate-specific membrane antigen (PSMA) PET/ CT for prostate cancer (PCA (4)), and 68 Ga-DOTATOC PET/ CT for gastroenteropancreatic neuroendocrine tumors (GEP NETs (5)). An exact evaluation of lymph node (LN) status before therapy is crucial to therapy planning. False-positive PET findings are not uncommon with 18 F-FDG PET/CT, because the scan can mistakenly pick up on inflammation due to infectious etiologies, such as in the lung or the h...

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“…Management is focused on surgical resection, with a lung‐sparing approach in paediatrics combined with lymph node dissection . There is insufficient evidence to support the use of chemotherapy, radiotherapy or somatostatin analogue therapy at the current time .…”

Section: Discussionmentioning

confidence: 99%

Bronchial carcinoid tumour identified as the cause for recurrent pneumonia in a 10‐year‐old boy

Mckenna

Trahair

2019

J Paediatrics Child Health

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Imaging in Neuroendocrine Tumors: An Update for the Clinician

Cited by 110 publications

References 49 publications

Carcinoid Syndrome: A Review

Carcinoid Syndrome: A Review

Correlation Between SUV_max and CT Radiomic Analysis Using Lymph Node Density in PET/CT-Based Lymph Node Staging

Bronchial carcinoid tumour identified as the cause for recurrent pneumonia in a 10‐year‐old boy

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Imaging in Neuroendocrine Tumors: An Update for the Clinician

Cited by 110 publications

References 49 publications

Carcinoid Syndrome: A Review

Carcinoid Syndrome: A Review

Correlation Between SUVmax and CT Radiomic Analysis Using Lymph Node Density in PET/CT-Based Lymph Node Staging

Bronchial carcinoid tumour identified as the cause for recurrent pneumonia in a 10‐year‐old boy

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Correlation Between SUV_max and CT Radiomic Analysis Using Lymph Node Density in PET/CT-Based Lymph Node Staging