open access

Vol 19, No 2 (2016)
Reviews
Published online: 2016-07-29
Submitted: 2016-07-08
Accepted: 2016-07-10
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NEN — the role of somatostatin receptor scintigraphy in clinical setting

Marta Opalińska, Alicja Hubalewska-Dydejczyk, Anna Sowa-Staszczak, Agnieszka Stefańska
DOI: 10.5603/NMR.2016.0023
·
Pubmed: 27479789
·
Nucl. Med. Rev 2016;19(2):118-125.

open access

Vol 19, No 2 (2016)
Reviews
Published online: 2016-07-29
Submitted: 2016-07-08
Accepted: 2016-07-10

Abstract

Detection of neuroendocrine neoplasms (NENs) and monitoring of their response to therapy is still challenging due to huge heterogeneity of that group of tumors. Actually, NENs visualization is mainly based on molecular imaging while in the past it was relied on less effective structural imaging including CT and MRI. Molecular imaging techniques in combination with structural imaging (hybrid imaging), especially in patients with well-differentiated NENs, in addition to morphological provide the functional information about tumor which benefits in a more accurate patient management, including more sensitive visualization of primary tumors, more precise staging and better therapy follow-up. Overexpression of somatostatin receptors (SSTR) on NENs’ cell membrane was a basis for development of somatostatin receptor scintigraphy (SRS) using single photon emission tomography SPECT, which is today a well-established standard in molecular imaging of NENs, and further imaging improvement in the field of positron emission tomography (PET). Use of hybrid imaging (SPECT/CT, PET/CT) increased sensitivity of examination, mainly resulting in better detection of small lesions. Generally, somatostatin receptor imaging with PET/CT is an emerging technique, although still with limited access, but due to several advantages over SSTR SPECT/CT, should be used if available. It is worth mentioning, that both SSTR PET/CT and SSTR SPECT/CT have some limitations, such as relatively low detection rate of benign insulinomas, poorly differentiated GEP-NETs and liver metastases. For that reason further improvement of NETs imaging is necessary. The most promising new tracers’ families are based on SSTR antagonists, 64Cu-radiolabeled ligands and glucagon-like peptide-1 receptor (GLP-1R) imaging. Finally, in case of poor-differentiated neuroendocrine cancers 18F-FDG PET/CT may be beneficial in comparison with molecular imaging based on somatostatin receptor modalities.

Abstract

Detection of neuroendocrine neoplasms (NENs) and monitoring of their response to therapy is still challenging due to huge heterogeneity of that group of tumors. Actually, NENs visualization is mainly based on molecular imaging while in the past it was relied on less effective structural imaging including CT and MRI. Molecular imaging techniques in combination with structural imaging (hybrid imaging), especially in patients with well-differentiated NENs, in addition to morphological provide the functional information about tumor which benefits in a more accurate patient management, including more sensitive visualization of primary tumors, more precise staging and better therapy follow-up. Overexpression of somatostatin receptors (SSTR) on NENs’ cell membrane was a basis for development of somatostatin receptor scintigraphy (SRS) using single photon emission tomography SPECT, which is today a well-established standard in molecular imaging of NENs, and further imaging improvement in the field of positron emission tomography (PET). Use of hybrid imaging (SPECT/CT, PET/CT) increased sensitivity of examination, mainly resulting in better detection of small lesions. Generally, somatostatin receptor imaging with PET/CT is an emerging technique, although still with limited access, but due to several advantages over SSTR SPECT/CT, should be used if available. It is worth mentioning, that both SSTR PET/CT and SSTR SPECT/CT have some limitations, such as relatively low detection rate of benign insulinomas, poorly differentiated GEP-NETs and liver metastases. For that reason further improvement of NETs imaging is necessary. The most promising new tracers’ families are based on SSTR antagonists, 64Cu-radiolabeled ligands and glucagon-like peptide-1 receptor (GLP-1R) imaging. Finally, in case of poor-differentiated neuroendocrine cancers 18F-FDG PET/CT may be beneficial in comparison with molecular imaging based on somatostatin receptor modalities.

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Keywords

NEN, NET imaging, octreotide, SRS, SRI, 99mTc-EDDA/HYNIC-TOC, 68Ga-PET/CT

About this article
Title

NEN — the role of somatostatin receptor scintigraphy in clinical setting

Journal

Nuclear Medicine Review

Issue

Vol 19, No 2 (2016)

Pages

118-125

Published online

2016-07-29

DOI

10.5603/NMR.2016.0023

Pubmed

27479789

Bibliographic record

Nucl. Med. Rev 2016;19(2):118-125.

Keywords

NEN
NET imaging
octreotide
SRS
SRI
99mTc-EDDA/HYNIC-TOC
68Ga-PET/CT

Authors

Marta Opalińska
Alicja Hubalewska-Dydejczyk
Anna Sowa-Staszczak
Agnieszka Stefańska

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