Bridging the Gap Between Clinical Suspicion of Neuroendocrine Tumors and Diagnosis With PET/CT When Pathology Is Unavailable

Abstract

A ccording to the European Neuroendocrine Tumor Society 2023 guidance article for gastroduodenal neuroendocrine tumors (NETs) G1-G3, 1 functional (ie, molecular) imaging, preferably using 68 Ga-labeled somatostatin receptor analogues (SSAs) PET/ CT, should be performed in one of the following indications: (a) type I gastric NETs presenting metastases on endoscopic ultrasound or high-risk features of metastatic spread (eg, high Ki-67, vascular invasion, size >20 mm); (b) type III gastric NETs; (c) duodenal NETs despite suboptimal value of PET in the localization of primary tumors; and (d) in the follow-up of gastric and duodenal G2-G3 metastatic NETs in cases of radioclinical discordance. In G3 tumors or high G2 NETs with negative 68 Ga-SSA PET/CT, 18