PET/CT assessment of neuroendocrine tumors of the lung with special emphasis on bronchial carcinoids.
Pulmonary neuroendocrine tumors (pNETs) arise from bronchial mucosal cells known as enterochromaffin cells which are part of the diffuse neuroendocrine system. The pathological spectrum of pNETs ranges from low-/intermediate-grade neoplasms such as bronchial carcinoids (BCs), also known as typical or atypical carcinoids, to high-grade neoplasms as large-cell neuroendocrine carcinoma and small-cell lung cancer. The tumor biology of pNETs still represents a matter of open debate. The distinct features among the different pNETs include not only their pathologic characteristics but also their clinical behavior, epidemiology, treatment, and prognosis. In this sense, a correct pathological identification in the preoperative setting is a key element for planning the best strategy of care in pNETs and especially in BCs. Controversial results have been reported on the diagnostic accuracy of fluorine-18-fluorodeoxyglucose positron emission tomography or positron emission tomography/computed tomography (F-18-FDG PET or PET/CT) in BCs. On the other hand, there is increasing evidence supporting the use of PET with somatostatin analogues (DOTA-TOC, DOTA-NOC, or DOTA-TATE) labeled with gallium-68 (Ga-68) in pNETs. Herein, we review the pertinent literature aiming to better define the current state of art of PET/CT in the detection and histological differentiation of pNETs with special emphasis on BCs.
Unit of Thoracic Surgery, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy, filippo_lococo@yahoo.it.
Filippo
F
Lococo
Alfredo
A
Cesario
Massimiliano
M
Paci
Angelina
A
Filice
Annibale
A
Versari
Cristian
C
Rapicetta
Tommaso
T
Ricchetti
Giorgio
G
Sgarbi
Marco
M
Alifano
Alberto
A
Cavazza
Giorgio
G
Treglia
D001984:Bronchial Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002276:Carcinoid Tumor / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D018358:Neuroendocrine Tumors / Q000175:diagnosis* / Q000000981:diagnostic imaging; D015282:Octreotide / Q000031:analogs & derivatives; D009942:Organometallic Compounds; D049268:Positron-Emission Tomography / Q000379:methods*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
C499142:Ga(III)-DOTATOC; D009942:Organometallic Compounds; D019788:Fluorodeoxyglucose F18; D015282:Octreotide