PET/CT and PET/MRI in neuroendocrine neoplasms

Rajamohan, Naveen; Khasawneh, Hala; Singh, Aparna; Suman, Garima; Johnson, Geoffrey B.; Majumder, Shounak; Halfdanarson, Thorvardur R.; Goenka, Ajit H.

doi:10.1007/s00261-022-03516-2

Cited by 11 publications

(7 citation statements)

References 82 publications

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“…With the introduction of PET/MRI systems, we are able to combine the analysis of SSTR-PET and MRI in NET. While it is well known that both SSTR-PET/CT and whole-body MRI show advantages and disadvantages in certain body areas [79], the combined analysis shows advantages regarding several aspects [80]-in particular, in overcoming potential discrepancies between lesion detection on MRI and SST-PET [81] and as a "one-stop shop" modality [82]. Figure 7 shows an example of a patient with a pancreatic NEN undergoing PET/MRI imaging.…”

Section: Pet/mrimentioning

confidence: 99%

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Gastroenteropancreatic Neuroendocrine Tumors—Current Status and Advances in Diagnostic Imaging

Vogele,

Schmidt,

Gnutzmann

et al. 2023

Diagnostics

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Gastroenteropancreatic neuroendocrine neoplasia (GEP-NEN) is a heterogeneous and complex group of tumors that are often difficult to classify due to their heterogeneity and varying locations. As standard radiological methods, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography–computed tomography (PET/CT) are available for both localization and staging of NEN. Nuclear medical imaging methods with somatostatin analogs are of great importance since radioactively labeled receptor ligands make tumors visible with high sensitivity. CT and MRI have high detection rates for GEP-NEN and have been further improved by developments such as diffusion-weighted imaging. However, nuclear medical imaging methods are superior in detection, especially in gastrointestinal NEN. It is important for radiologists to be familiar with NEN, as it can occur ubiquitously in the abdomen and should be identified as such. Since GEP-NEN is predominantly hypervascularized, a biphasic examination technique is mandatory for contrast-enhanced cross-sectional imaging. PET/CT with somatostatin analogs should be used as the subsequent method.

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Section: Pet/mrimentioning

confidence: 99%

“…analysis shows advantages regarding several aspects [80]-in particular, in overcoming potential discrepancies between lesion detection on MRI and SST-PET [81] and as a "onestop shop" modality [82]. Figure 7 shows an example of a patient with a pancreatic NEN undergoing PET/MRI imaging.…”

Section: Pet/mrimentioning

confidence: 99%

Gastroenteropancreatic Neuroendocrine Tumors—Current Status and Advances in Diagnostic Imaging

Vogele,

Schmidt,

Gnutzmann

et al. 2023

Diagnostics

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“…Somatostatin receptor PET/CT is observed to be superior to Octreoscan because of the ability to quantify radiotracer uptake, the higher affinity of PET pharmaceuticals to the SSTR, the shorter scan duration, lower radiation exposure, and higher spatial resolution. 54 It is the primary imaging modality for the functional workup of the SB-NEN. 47 Currently, the SSTR PET is performed with 68 -Gallium ( 68 Ga) tagged peptides, such as Tyr3-Octreotide (TATE), TyI3-Octreotide (TOC), or NaI3-Octreotide (NOC).…”

Section: Somatostatin Receptor Pet/ctmentioning

confidence: 99%

Small Bowel Neuroendocrine Neoplasms—A Review

Vulasala,

Virarkar,

Gopireddy

et al. 2023

J Comput Assist Tomogr

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Neuroendocrine neoplasms (NENs) are rapidly evolving small bowel tumors, and the patients are asymptomatic at the initial stages. Metastases are commonly observed at the time of presentation and diagnosis. This review addresses the small bowel NEN (SB-NEN) and its molecular, histological, and imaging features, which aid diagnosis and therapy guidance. Somatic cell number alterations and epigenetic mutations are studied to be responsible for sporadic and familial SB-NEN. The review also describes the grading of SB-NEN in addition to rare histological findings such as mixed neuroendocrine-non-NENs. Anatomic and nuclear imaging with conventional computed tomography, magnetic resonance imaging, computed tomographic enterography, and positron emission tomography are adopted in clinical practice for diagnosing, staging, and follow-up of NEN. Along with the characteristic imaging features of SB-NEN, the therapeutic aspects of imaging, such as peptide receptor radionuclide therapy, are discussed in this review.

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“…In addition, there has also been a significant increase in diagnostic and therapeutic options for these patients 10 . This includes the use of gallium‐68 DOTA‐Tyr3‐octreotate (DOTATATE), which received Food and Drug Administration approval in 2016 11,12 . Since then, DOTATATE positron emission tomography (PET) imaging has been more commonly utilized due to its presumed high diagnostic accuracy and ability to detect additional intra and extrahepatic metastatic disease that was previously undetected by conventional computed tomography (CT) and magnetic resonance imaging (MRI) 13 .…”

Section: Introductionmentioning

confidence: 99%

“…10 This includes the use of gallium-68 DOTA-Tyr3-octreotate (DOTATATE), which received Food and Drug Administration approval in 2016. 11,12 Since then, DOTATATE positron emission tomography (PET) imaging has been more commonly utilized due to its presumed high diagnostic accuracy and ability to detect additional intra and extrahepatic metastatic disease that was previously undetected by conventional computed tomography (CT) and magnetic resonance imaging (MRI). 13 However, the accuracy of DOTATATE PET imaging for preoperative surgical planning for the management of local or regional sbNET disease remains unproven.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of DOTATATE PET imaging in the preoperative planning of small bowel neuroendocrine tumor resection

Zhang,

Gudmundsdottir,

Takahashi

et al. 2023

Journal of Surgical Oncology

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Background and ObjectivesWe assessed the accuracy of preoperative gallium‐68 DOTA‐Tyr3‐octreotate (DOTATATE) positron emission tomography (PET) imaging in estimating multifocality and nodal metastases of small bowel neuroendocrine tumors (sbNETs).MethodsA multicenter analysis was performed on patients with sbNETs who underwent preoperative DOTATATE PET imaging and surgical resection, with manual palpation of the entire length of the small bowel, between January 2016 and August 2022. Preoperative imaging reports and blinded secondary imaging reviews were compared to the final postoperative pathology reports. Descriptive statistics were applied.ResultsOne‐hundred and four patients met inclusion criteria. Pathology showed 53 (51%) patients had multifocal sbNETs and 96 (92%) had nodal metastases. The original preoperative DOTATATE PET imaging identified multifocal sbNET in 28 (27%) patients and lymph node (LN) metastases in 80 (77%) patients. Based on original radiology reports, sensitivity for multifocal sbNET identification was 45%, specificity was 92%, positive predictive value (PPV) was 86%, and negative predictive value (NPV) was 62%. For the identification of LN metastases, sensitivity was 82%, specificity was 88%, PPV was 99%, and NPV was 29%.ConclusionsAlthough DOTATATE PET imaging is specific and relatively accurate, sensitivity and NPV are insufficient to guide surgical planning. Preoperative use should not replace open palpation to identify additional synchronous lesions or to omit regional lymphadenectomy.

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PET/CT and PET/MRI in neuroendocrine neoplasms

Cited by 11 publications

References 82 publications

Gastroenteropancreatic Neuroendocrine Tumors—Current Status and Advances in Diagnostic Imaging

Gastroenteropancreatic Neuroendocrine Tumors—Current Status and Advances in Diagnostic Imaging

Small Bowel Neuroendocrine Neoplasms—A Review

Accuracy of DOTATATE PET imaging in the preoperative planning of small bowel neuroendocrine tumor resection

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