title: [Contemporary nuclear medicine diagnostics of neuroendocrine tumors].
abstract: The new positron emission tomography (PET/CT) methods for neuroendocrine tumors detection are presented and compared with classic, conventional methods. Conventional methods use a gamma scintillation camera for patients with neuroendocrine tumor imaging, after intravenous injection of one of the following radiopharmaceuticals: 1) somatostatin analogues labeled with indium-111 (111In-pentetreotide) or technetium-99m (99mTc-EDDA/HYNIC-TOC); 2) noradrenaline analogue labeled with iodine-131 or -123 (131/123I-MIBG); or 3) 99mTc(V)-DMSA. Contemporary methods use PET/CT equipment for patients with neuroendocrine tumor imaging, after intravenous injection of pharmaceuticals labeled with positron emitters [fluorine-18 (18F), galium-68 (68Ga), or carbon-11 (11C)]: 1) glucose analogue (18FDG); 2) somatostatin analogue (68Ga-DOTATOC/68Ga-DOTATATE/68Ga-DOTANOC); 3) aminoacid precursors of bioamines: [a) dopamine precursor 18F-DOPA (6-18F-dihydroxyphenylalanine), b) serotonin precursor 11C-5HTP (11C-5-hydroxytryptophan)]; or 4) dopamine analogue 18F-DA (6-18F-fluorodopamine). Conventional and contemporary (PET/ CT) somatostatin receptor detection showed identical high spe- cificity (92%), but conventional had very low sensitivity (52%) compared to PET/CT (97%). It means that almost every second neuroendocrine tumor detected by contemporary method cannot be discovered using conventional (classic) method. In metastatic pheochromocytoma detection contemporary (PET/ CT) methods (18F-DOPA and 18F-DA) have higher sensitivity than conventional (131I/123I-MIBG). In medullary thyroid carcinoma diagnostics contemporary method ([18F-DOPA) is more sensitive than conventional 99mTc(V)-DMSA method, and is similar to 18FDG, computed tomography and magnetic resonance. In carcinoid detection contemporary method (18F-DOPA) shows similar results with contemporary somatostatin receptor detection, while for gastroenteropancreatic neuroendocrine tumors it is worse. To conclude, contemporary (PET/CT) methods for somatostatin receptor detection (68Ga-DOTATOC/-NOC/-TATE) in neuroendocrine tumors are much more sensitive (almost twice) and more accurate than conventional. Therefore the classical methods should be urgently replaced by contemporary methods.
mesh_terms: D000310:Adrenal Gland Neoplasms; D004295:Dihydroxyphenylalanine; D004298:Dopamine / Q000031:analogs & derivatives; D006801:Humans; D007414:Intestinal Neoplasms / Q000000981:diagnostic imaging*; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging*; D009683:Nuclear Medicine; D015282:Octreotide / Q000031:analogs & derivatives; D009942:Organometallic Compounds; D015609:Organotechnetium Compounds; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D000072078:Positron Emission Tomography Computed Tomography; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013004:Somatostatin / Q000031:analogs & derivatives; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
chemical_list: C504894:68Ga-DOTANOC; C499142:Ga(III)-DOTATOC; D009942:Organometallic Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C410263:technetium Tc 99m hydrazinonicotinyl-Tyr(3)-octreotide; D013004:Somatostatin; C029253:6-fluorodopamine; D004295:Dihydroxyphenylalanine; C081788:pentetreotide; D015282:Octreotide; C106246:Edotreotide; D004298:Dopamine