Use of Molecular Imaging to Differentiate Liver Metastasis of Colorectal Cancer Metastasis From Neuroendocrine Tumor Origin

Desai, Kiran; Watkins, Jennifer; Woodward, Nicholas; Quigley, Anne Marie; Toumpanakis, Christos; Bomanji, Jamshed; Caplin, Martyn

doi:10.1097/mcg.0b013e3181e04d3c

Cited by 7 publications

(3 citation statements)

References 15 publications

(14 reference statements)

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“…However no sufficient data are available about the role of 68 Ga-SST-analogues PET/CT in this clinical setting [80, 81]. Desai et al [81] reported the usefulness of molecular imaging using different PET radiotracers in order to understand NET biology and subsequently to determine the best treatment option. In this case a different tumor pattern of [ 18 F]FDG and 68 Ga-DOTATATE uptake was shown by PET examinations within the liver, resulting in synchronous colorectal cancer and pancreatic NET liver metastases.…”

Section: Colorectal Cancermentioning

confidence: 99%

PET and PET/CT with⁶⁸Gallium-Labeled Somatostatin Analogues in Non GEP-NETs Tumors

Sollini

Erba

Fraternali

et al. 2014

The Scientific World Journal

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Somatostatin (SST) is a 28-amino-acid cyclic neuropeptide mainly secreted by neurons and endocrine cells. A major interest for SST receptors (SSTR) as target for in vivo diagnostic and therapeutic purposes was born since a series of stable synthetic SST-analouges PET became available, being the native somatostatin non feasible for clinical use due to the very low metabolic stability. The rationale for the employment of SST-analogues to image cancer is both based on the expression of SSTR by tumor and on the high affinity of these compounds for SSTR. The primary indication of SST-analogues imaging is for neuroendocrine tumors (NETs), which usually express a high density of SSTR, so they can be effectively targeted and visualized with radiolabeled SST-analogues in vivo. Particularly, SST-analogues imaging has been widely employed in gastroenteropancreatic (GEP) NETs. Nevertheless, a variety of tumors other than NETs expresses SSTR thus SST-analogues imaging can also be used in these tumors, particularly if treatment with radiolabeled therapeutic SST-analouges PET is being considered. The aim of this paper is to provide a concise overview of the role of positron emission tomography/computed tomography (PET/CT) with 68Ga-radiolabeled SST-analouges PET in tumors other than GEP-NETs.

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Section: Colorectal Cancermentioning

confidence: 99%

PET and PET/CT with⁶⁸Gallium-Labeled Somatostatin Analogues in Non GEP-NETs Tumors

Sollini

Erba

Fraternali

et al. 2014

The Scientific World Journal

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“…This case suggested that combinational 68 Ga-DOTATATE PET and 18 F-FDG PET imaging modalities are of potential use in understanding the biology of the NETs and managing the NETs [38]. …”

Section: The Clinical Use Of Radioisotope Labeled Sstr In Netsmentioning

confidence: 99%

Somatostatin Receptor-Based Molecular Imaging and Therapy for Neuroendocrine Tumors

Tang

Zhang

et al. 2013

BioMed Research International

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Neuroendocrine tumors (NETs) are tumors originated from neuroendocrine cells in the body. The localization and the detection of the extent of NETs are important for diagnosis and treatment, which should be individualized according to the tumor type, burden, and symptoms. Molecular imaging of NETs with high sensitivity and specificity is achieved by nuclear medicine method using single photon-emitting and positron-emitting radiopharmaceuticals. Somatostatin receptor imaging (SRI) using SPECT or PET as a whole-body imaging technique has become a crucial part of the management of NETs. The radiotherapy with somatostatin analogues labeled with therapeutic beta emitters, such as lutetium-177 or yttrium-90, has been proved to be an option of therapy for patients with unresectable and metastasized NETs. Molecular imaging can deliver an important message to improve the outcome for patients with NETs by earlier diagnosis, better choice of the therapeutic method, and evaluation of the therapeutic response.

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“…2). Indeed, Desai et al [44] reported an interesting case in which molecular imaging was used to differentiate hepatic metastases originating from colorectal cancer and hepatic metastases originating from an NET in the same patient. An 18 F-FDG PET is therefore recommended for NET patients who develop new indeterminate tumor lesions with cross-sectional imaging whenever there is a past medical history of a second malignancy or when a second primary is suspected (level of evidence 4, grade of recommendation C).…”

Section: Recommendations For Specific Clinical Scenariosmentioning

confidence: 99%

Combination of Cross-Sectional and Molecular Imaging Studies in the Localization of Gastroenteropancreatic Neuroendocrine Tumors

et al. 2014

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Molecular imaging modalities exploit aspects of neuroendocrine tumors (NET) pathophysiology for both diagnostic imaging and therapeutic purposes. The characteristic metabolic pathways of NET determine which tracers are useful for their visualization. In this review, we summarize the diagnostic value of all available molecular imaging studies, present data about their use in daily practice in NET centers globally, and finally make recommendations about the appropriate use of those modalities in specific clinical scenarios. Somatostatin receptor scintigraphy (SRS) continues to have a central role in the diagnostic workup of patients with NET, as it is also widely available. However, and despite the lack of prospective randomized studies, many NET experts predict that Gallium-68 (⁶⁸Ga)-DOTA positron emission tomography (PET) techniques may replace SRS in the future, not only because of their technical advantages, but also because they are superior in patients with small-volume disease, in patients with skeletal metastases, and in those with occult primary tumors. Carbon-11 (¹¹C)-5-hydroxy-L-tryptophan (5-HTP) PET and ¹⁸F-dihydroxyphenylalanine (¹⁸F-DOPA) PET are new molecular imaging techniques of limited availability, and based on retrospective data, their sensitivities seem to be inferior to that of ⁶⁸Ga-DOTA PET. Glucagon-like-peptide-1 (GLP-1) receptor imaging seems promising for localization of the primary in benign insulinomas, but is currently available only in a few centers. Fluorine-18 (¹⁸F)-fluorodeoxyglucose (¹⁸F-FDG) PET was initially thought to be of limited value in NET, due to their usually slow-growing nature. However, according to subsequent data, ¹⁸F-FDG PET is particularly helpful for visualizing the more aggressive NET, such as poorly differentiated neuroendocrine carcinomas, and well-differentiated tumors with Ki67 values >10%. According to limited data, ¹⁸F-FDG-avid tumor lesions, even in slow-growing NET, may indicate a more aggressive disease course. When a secondary malignancy has already been established or is strongly suspected, combining molecular imaging techniques (e.g. ¹⁸F-FDG PET and ⁶⁸Ga-DOTA PET) takes advantage of the diverse avidities of different tumor types to differentiate lesions of different origins. All the above-mentioned molecular imaging studies should always be reviewed and interpreted in a multidisciplinary (tumor board) meeting in combination with the conventional cross-sectional imaging, as the latter remains the imaging of choice for the evaluation of treatment response and disease follow-up.

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Use of Molecular Imaging to Differentiate Liver Metastasis of Colorectal Cancer Metastasis From Neuroendocrine Tumor Origin

Cited by 7 publications

References 15 publications

PET and PET/CT with⁶⁸Gallium-Labeled Somatostatin Analogues in Non GEP-NETs Tumors

PET and PET/CT with⁶⁸Gallium-Labeled Somatostatin Analogues in Non GEP-NETs Tumors

Somatostatin Receptor-Based Molecular Imaging and Therapy for Neuroendocrine Tumors

Combination of Cross-Sectional and Molecular Imaging Studies in the Localization of Gastroenteropancreatic Neuroendocrine Tumors

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Use of Molecular Imaging to Differentiate Liver Metastasis of Colorectal Cancer Metastasis From Neuroendocrine Tumor Origin

Cited by 7 publications

References 15 publications

PET and PET/CT with68Gallium-Labeled Somatostatin Analogues in Non GEP-NETs Tumors

PET and PET/CT with68Gallium-Labeled Somatostatin Analogues in Non GEP-NETs Tumors

Somatostatin Receptor-Based Molecular Imaging and Therapy for Neuroendocrine Tumors

Combination of Cross-Sectional and Molecular Imaging Studies in the Localization of Gastroenteropancreatic Neuroendocrine Tumors

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PET and PET/CT with⁶⁸Gallium-Labeled Somatostatin Analogues in Non GEP-NETs Tumors

PET and PET/CT with⁶⁸Gallium-Labeled Somatostatin Analogues in Non GEP-NETs Tumors