Molecular profiling and target actionability for precision medicine in neuroendocrine neoplasms: real-world data

Boilève, Alice; Faron, Matthieu; Fodil-Cherif, Sarah; Bayle, Arnaud; Lamartina, Livia; Planchard, David; Tselikas, Lambros; Kanaan, Christina; Scoazec, Jean Yves; Ducreux, Michel; Italiano, Antoîne; Baudin, Éric; Hadoux, Julien

doi:10.1016/j.ejca.2023.03.024

Cited by 4 publications

(1 citation statement)

References 26 publications

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“…In consideration of these possible false-negative biopsy results, histologic verification of PET-positive liver lesions appears redundant in cases of patients with histologically proven NETs, and functional imaging with SSR-PET/CT might reduce unnecessary further biopsies. However, one must be aware that biopsies are nowadays not only used for pure histological confirmation of metastases but are also required for additional molecular diagnostics in precision medicine [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of SSR-PET/CT compared to histopathology in the identification of liver metastases from well-differentiated neuroendocrine tumors

Fabritius,

Soltani,

Cyran

et al. 2023

Cancer Imaging

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Background Histopathology is the reference standard for diagnosing liver metastases of neuroendocrine tumors (NETs). Somatostatin receptor-positron emission tomography / computed tomography (SSR-PET/CT) has emerged as a promising non-invasive imaging modality for staging NETs. We aimed to assess the diagnostic accuracy of SSR-PET/CT in the identification of liver metastases in patients with proven NETs compared to histopathology. Methods Histopathologic reports of 139 resected or biopsied liver lesions of patients with known NET were correlated with matching SSR-PET/CTs and the positive/negative predictive value (PPV/NPV), sensitivity, specificity, and diagnostic accuracy of SSR-PET/CT were evaluated. PET/CT reading was performed by one expert reader blinded to histopathology and clinical data. Results 133 of 139 (95.7%) liver lesions showed malignant SSR-uptake in PET/CT while initial histopathology reported on ‘liver metastases of NET´ in 127 (91.4%) cases, giving a PPV of 91.0%. Re-biopsy of the initially histopathologically negative lesions (reference standard) nevertheless diagnosed ‘liver metastases of NET’ in 6 cases, improving the PPV of PET/CT to 95.5%. Reasons for initial false-negative histopathology were inadequate sampling in the sense of non-target biopsies. The 6 (4.3%) SSR-negative lesions were all G2 NETs with a Ki-67 between 2–15%. Conclusion SSR-PET/CT is a highly accurate imaging modality for the diagnosis of liver metastases in patients with proven NETs. However, we found that due to the well-known tumor heterogeneity of NETs, specifically in G2 NETs approximately 4–5% are SSR-negative and may require additional imaging with [18F]FDG PET/CT.

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Section: Discussionmentioning

confidence: 99%