title: Neuroendocrine tumours: the role of imaging for diagnosis and therapy.
abstract: In patients with neuroendocrine tumours (NETs), a combination of morphological imaging and nuclear medicine techniques is mandatory for primary tumour visualization, staging and evaluation of somatostatin receptor status. CT and MRI are well-suited for discerning small lesions that might escape detection by single photon emission tomography (SPECT) or PET, as well as for assessing the local invasiveness of the tumour or the response to therapy. Somatostatin receptor imaging, by (111)In-pentetreotide scintigraphy or PET with (68)Ga-labelled somatostatin analogues, frequently identifies additional lesions that are not visible on CT or MRI scans. Currently, somatostatin receptor scintigraphy with (111)In-pentetreotide is the more frequently available of the two techniques to determine somatostatin receptor expression and is needed to select patients for peptide receptor radionuclide therapy. In the future, because of its higher sensitivity, PET with (68)Ga-labelled somatostatin analogues is expected to replace somatostatin receptor scintigraphy. Whereas (18)F-FDG-PET is only used in high-grade neuroendocrine cancers, PET-CT with (18)F-dihydroxy-L-phenylalanine or (11)C-5-hydroxy-L-tryptophan is a useful problem-solving tool and could be considered for the evaluation of therapy response in the future. This article reviews the role of imaging for the diagnosis and management of intestinal and pancreatic NETs. Response evaluation and controversies in NET imaging will also be discussed.
authors: Department of Nuclear Medicine, Erasmus MC, 's Gravendijkwal 230, Rotterdam, 3015 GD, Netherlands.
authors: Martijn
authors: M
authors: van Essen
authors: Department of Radiology, Karolinska University Hospital, Stockholm, 17176 Stockholm, Sweden.
authors: Anders
authors: A
authors: Sundin
authors: Department of Nuclear Medicine, Erasmus MC, 's Gravendijkwal 230, Rotterdam, 3015 GD, Netherlands.
authors: Eric P
authors: EP
authors: Krenning
authors: Department of Nuclear Medicine, Erasmus MC, 's Gravendijkwal 230, Rotterdam, 3015 GD, Netherlands.
authors: Dik J
authors: DJ
authors: Kwekkeboom
mesh_terms: D003952:Diagnostic Imaging / Q000379:methods*; D006801:Humans; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D018358:Neuroendocrine Tumors / Q000175:diagnosis* / Q000188:drug therapy*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000188:drug therapy*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals