title: Frequency and characterization of gastro-entero-pancreatic neuroendocrine tumor patients with high-grade of uptake at somatostatin receptor scintigraphy.
abstract: Recent studies suggest that the somatostatin receptor scintigraphy (SRS) grade of uptake is a predictor of response to peptide receptor radionuclide therapy (PRRT). To identify and characterize patients with well-differentiated (WD) neuroendocrine neoplasm (NEN) displaying a high-grade uptake at SRS. Patients with WD-NEN, whose SRS films were available for review, were retrospectively included. SRS was reviewed by three independent readers and classified into four subgroups based on a modified Krenning's scale (mKS): no uptake (group-0), homogeneous grade 1-2 uptake (group-1), homogeneous grade 3-4 (group-2), and heterogeneous grade 1-4 (group-3). A simplified scale (sS) of SRS was also used to look for characteristics of patients with high-grade uptake. One hundred and six WD-NEN patients were enrolled. Group-0, group-1, group-2, and group-3 were found in 17, 8, 33, and 42% of cases respectively. High-grade uptake at sS (75% of cases) was correlated with older age, functioning NEN, high chromogranin-A level, and grade 1 (G1) NEN based on mitotic count. Based on the mKS or sS scales, no difference on survival was found. Thirty-three to seventy-five percent of metastatic NEN patients can be considered candidates for PRRT based on homogeneous or heterogeneous high-grade uptake. Functioning G1 NEN patients could be the best candidates for PRRT. Randomized trials are expected to confirm this result.
authors: Departments of Nuclear Medicine and Endocrine Tumors, Institut Gustave Roussy, University Paris-Sud, 114 Rue Edouard Vaillant, 94805 Villejuif Cedex, France.
authors: Cecile N
authors: CN
authors: Chougnet
authors: Sophie
authors: S
authors: Leboulleux
authors: Caroline
authors: C
authors: Caramella
authors: Jean
authors: J
authors: Lumbroso
authors: Isabelle
authors: I
authors: Borget
authors: Désirée
authors: D
authors: Déandreis
authors: Pierre
authors: P
authors: Duvillard
authors: Dominique
authors: D
authors: Elias
authors: Thierry
authors: T
authors: de Baere
authors: Fritz-Line
authors: FL
authors: Vélayoudom-Céphise
authors: Joël
authors: J
authors: Guigay
authors: Michel
authors: M
authors: Ducreux
authors: Martin
authors: M
authors: Schlumberger
authors: Eric
authors: E
authors: Baudin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053379:Chromogranin A / Q000097:blood; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D011877:Radionuclide Imaging; D017481:Receptors, Somatostatin / Q000378:metabolism*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D053379:Chromogranin A; D017481:Receptors, Somatostatin