Recent advances in radiological and radionuclide imaging and therapy of neuroendocrine tumours

Kaltsas, Gregory; Rockall, Andrea; Papadogias, Dimitrios; Reznek, Rodney H.; Grossman, Ashley

doi:10.1530/eje.0.1510015

Cited by 187 publications

(113 citation statements)

References 101 publications

(135 reference statements)

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“…Although these receptors are not restricted only to NETs, scintigraphy with 111 In-labelled octreotide (Octreoscan) has offered a highly sensitive tool which, when used in the relevant clinical setting, identifies and localises the tumour in patients with NETs (Krenning et al 1993, Olsen et al 1995, Kaltsas et al 2004aFig. 4).…”

Section: Octreotide Scintigraphymentioning

confidence: 99%

“…4). The Octreoscan achieves a sensitivity that ranges between 67 and 100%, depending on the tumour type, and can be used for the diagnosis, staging and follow-up of patients with NETs (Krenning et al 1993, Kaltsas et al 2004a; occasionally, false positive results have been reported (Kwekkeboom & Krenning 2002). A number of NETs may still not be identified with this technique, most probably due to their small tumour size or less expression of the relevant SSTR subtypes 2 and 5;…”

Section: Octreotide Scintigraphymentioning

confidence: 99%

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Paraneoplastic syndromes secondary to neuroendocrine tumours

Kaltsas

Androulakis²,

Herder³

et al. 2010

Endocrine-Related Cancer

100

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Neuroendocrine tumours may be either benign or malignant tumours, and have the ability to synthesise and secrete biologically active substances characteristic of the cell of origin that can cause distinct clinical syndromes. The term 'paraneoplastic syndromes' (PNSs) is used to denote syndromes secondary to substances secreted from tumours not related to their specific organ or tissue of origin and/or production of autoantibodies against tumour cells; such syndromes are mainly associated with hormonal and neurological symptoms. Appreciation of the presence of such syndromes is important as clinical presentation, if not identified, may delay the diagnosis of the underlying neoplasia. Conversely, early recognition can allow for more rapid diagnosis, particularly as the coexistence of a neoplasm with a clinical or biochemical marker offers an additional determinant of tumour status/progression. PNSs can complicate the patient's clinical course, response to treatment, impact prognosis and even be confused as metastatic spread. Their diagnosis involves a multidisciplinary approach, and detailed endocrinological, neurological, radiological and histological studies are required. Correct diagnosis is essential as the treatment of choice will be different for each disorder, particularly in the case of malignant tumours; it is therefore important to develop appropriate means to correctly identify and localise these tumours. Clinical awareness and the incorporation into clinical practise of 111 In-octreotide scintigraphy, chromogranin A and other evolving biochemical marker measurement techniques have substantially contributed to the identification of patients harbouring such syndromes. Diseasespecific medical therapies are mandatory in order to prevent recurrence and/or further tumour growth. Owing to their rarity, central registration of these syndromes is very helpful in order to be able to provide evidence-based diagnostic and therapeutic approaches.

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Section: Octreotide Scintigraphymentioning

confidence: 99%

Section: Octreotide Scintigraphymentioning

confidence: 99%

Paraneoplastic syndromes secondary to neuroendocrine tumours

Kaltsas

Androulakis²,

Herder³

et al. 2010

Endocrine-Related Cancer

100

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“…Localizing the disease and determining the degree to which it has spread is of great importance for the process of choosing the appropriate therapy, which is why the diagnosis of NETs includes various visualization techniques, including echosonography, computerised tomography, magnetic resonance imaging, positron emission tomography, endoscopic ultrasound and different nuclear medicine visualization methods [6,7]. Over 90% of carcinoids and other NETs are characterized by excessive expression of somatostatin receptors, especially the sstr2 subtype, which is the molecular basis of their in vivo localization and the clinical application of somatostatin analogue in the treatment of these tumors.…”

Section: Introductionmentioning

confidence: 99%

The influence of Ki-67 proliferation index on Tc-99m-EDDA-HYNIC-TOC somatostatin receptor scintigraphy in patients with carcinoids

et al. 2014

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Abstract:The aim of this paper is to determine the influence of Ki-67 proliferation index on somatostatin receptor scintigraphy (SSRS) with Tc-99m-EDDA-HYNIC-TOC (Tc-99m-Tektrotyd) somatostatin analogue in patients with carcinoid tumors. Sixty-one patients (31 female, 30 male; age range: 33-76 years) were examined: 13 patients highly suspected of having a carcinoid, and 48 patients who had undergone the surgical removal of the tumor. Whole body SSRS at 4 h postinjection, spot scintigrams and SPECT of the selected regions were obtained for all patients. Tc-99m-Tektrotyd scintigraphy was classified as true positive in 26 out of 30 and true negative in 24 out of 28 patients. The sensitivity of Tc-99mTc-Tektrotyd scintigraphy was found to be as high as 94.74% in the group of patients with low mitotic index Ki67 (<2%), and it progressively decreased in patients with higher mitotic index (77.78% for Ki67 2-15% and 20% for Ki67% >20%). The likelihood of Tc-99m-Tektrotyd scan being positive when a carcinoid is present was found to be inversely proportional to the value of Ki67 proliferation index. The results showed that Tc-99m-Tektrotyd SSRS is a sensitive method for diagnosing and staging patients with well-differentiated carcinoid tumors. However, in poorly differentiated tumors with high Ki67 proliferation index, additional analyses are necessary for precise staging.

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“…The sensitivity of this method increases for detecting hepatic metastases, where it amounts to 50-80%. For larger tumours, mostly non-secreting pancreatic tumours and late-diagnosed glucagonoma, the sensitivity of transabdominal USG is higher [6,[76][77][78].…”

Section: Transabdominal Ultrasonographymentioning

confidence: 99%

“…Neuroendocrine tumours, particularly those with a high connective tissue content, cause limitation of the diffusion of water molecules, which generates intense signals in the DWI sequence, accompanied by lowered ADC. DWI is particularly valuable in tumours with a significant connective tissue component, which are poorly or atypically enhanced after intravenous administration of the contrast agent [6,76,105].…”

Section: Magnetic Resonance (Mri)mentioning

confidence: 99%