Nuclear Medicine in Patients with NET: Radiolabeled Somatostatin Analogues and their Brothers.
Although Somastostatin (SS) scintigraphy (SRS) has been introduced many years ago, it remains the most diffuse radionuclide diagnostic tool in patients with neuroendocrine tumours (NETs). Being SS receptors (SSTR) expressed in the majority of NETs, radiolabeled SS analogues (SS-A) provide high diagnostic accuracy, mainly in patients with gastro-entero-pancreatic (GEP) tumors. SSTR are the best target for radiotracers used either for diagnostic and therapeutic purposes in NETs due to their presence on the surface of neoplastic cells of clinical interest. 111In- DTPA-octreotide (111In-Pentetreotide, Octreoscan®), may detect either primitive or secondary lesions in the presence of a satisfactory lesion/background ratio. The unsatisfactory diagnostic performance of 18F-Fluorodeoxyglucose (18F-FDG), in NETs stimulated the synthesis of more specific positron-emitting tracers and SS-A labeled with 68Gallium (DOTA-peptides) represent actually the best radionuclide procedure for NET imaging. Alternative radiotracers, labeled either with gamma or positron emitters and showing different uptake mechanisms, as 18F-DOPA (Fluorine- 18-L-dihydroxyphenylalanine), have also been proposed and clinically utilized. Octreoscan®, despite its limitations, continue to represent the most frequently used method in evaluating the response to treatment and in follow-up of patients with NET, although the better diagnostic accuracy of DOTA-peptides.
Nuclear Medicine Unit, Department of Clinical and Experimental Medicine ''F.Magrassi, A.Lanzara'' - Seconda Università di Napoli, Napoli. Italy.
Vincenzo
V
Cuccurullo
Nuclear Medicine Unit, Department of Clinical and Experimental Medicine ''F.Magrassi, A.Lanzara'' - Seconda Università di Napoli, Napoli. Italy.
Maria R
MR
Prisco
Nuclear Medicine Unit, Department of Clinical and Experimental Medicine ''F.Magrassi, A.Lanzara'' - Seconda Università di Napoli, Napoli. Italy.
Giuseppe D
GD
Di Stasio
Medicina Nucleare, Seconda Università di Napoli, P.zza Miraglia, 80138 Napoli. Italy.
Luigi
L
Mansi
D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives; D019788:Fluorodeoxyglucose F18; D006801:Humans; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging*; D009683:Nuclear Medicine / Q000379:methods; D015282:Octreotide / Q000031:analogs & derivatives; D009942:Organometallic Compounds; D000072078:Positron Emission Tomography Computed Tomography; D019275:Radiopharmaceuticals / Q000494:pharmacology*; D013004:Somatostatin / Q000031:analogs & derivatives*
D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C094279:indium-111-octreotide; D019788:Fluorodeoxyglucose F18; C043437:fluorodopa F 18; D013004:Somatostatin; D004295:Dihydroxyphenylalanine; C513399:gallium Ga 68 dotatate; C081788:pentetreotide; D015282:Octreotide
18F-DOPA; DOTA-peptides; PET/CT; SPECT/CT.; Somatostatin analogues; octreoscan®