Predictive Value of ¹⁸F-FDG PET and Somatostatin Receptor Scintigraphy in Patients with Metastatic Endocrine Tumors

Evolving role of molecular imaging with PET in detecting and characterizing heterogeneity of cancer tissue at the primary and metastatic sites, a plausible explanation for failed attempts to cure malignant disorders

“…[ DOTA-TOC uptake) and an associated significant increase in glycolytic metabolism (leading to increased FDG uptake) [17][18][19][20][21]. Again, high FDG avidity in the tumors is usually associated with a worse patient prognosis [22,23]. Similar to what has been noted with thyroid cancer, it is not uncommon to visualize two or even three types of lesions in the same patient with NET where each group of abnormal tissues shows varying degrees of glycolysis, SSTR concentration, and dopaminergic metabolism.…”

Imaging of gastroenteropancreatic neuroendocrine tumors

“…Another small study performed by Pasquali et al [69] evaluated the clinical use of FDG PET against conventional gamma-based SRS and CT, and again found that FDG PET was able to detect NETs characterized by rapid growth or aggressive behavior. Garin et al [70] performed a prospective study evaluating the clinical outcomes of 38 patients with metastatic NETs. FDG PET, SRS and conventional CT were performed for these patients, and patients were tracked to determine progression-free survival and overall survival.…”

Pancreatic Neuroendocrine Tumors: an Update

“…PET is best suited for the identification of rapidly progressive tumors. Usually, high FDG avidity correlates with poorly differentiated pNETs and increased mortality risk [31,32]. Recently, the use of 68 Ga-labeled somatostatin analogs has been proposed by several authors and shown to be superior to both SRS and conventional cross-sectional imaging [33][34][35][36].…”

“…TAE utilizes occlusive particles alone (often referred to as bland embolization) while TACE benefits from the addition of chemotherapeutic agents (e.g., 5- fluorouracile, cisplatin, streptozocyn, antracycline, etc.). TACE has been shown to offer a higher response rate and a slight survival advantage compared to TAE, although a general consensus is still lacking [30,31,74,75]. Portal vein thrombosis, ascites, and liver failure are absolute contraindications for TAE/TACE.…”