Radioguided surgery with radiolabeled somatostatin analogs: not only in GEP-NETs

Cuccurullo, Vincenzo; Stasio, Giuseppe Danilo Di; Mansi, Luigi

doi:10.5603/nmr.2017.0003

Cited by 26 publications

(21 citation statements)

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“…8 Apart from malignant cells, these receptors are expressed by inflammatory cells and cells of the innate and adaptive immune system. 9 The SSTRs signal to alter hormonal secretion, augment apoptosis, and reduce cellular proliferation. Their expression by endocrine tumors is critical for the use of the somatostatin analogs in pharmacotherapy.…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of 99MTC-hynic-toc Scintigraphy in Lung Neuroendocrine Tumor Diagnosis

Boutsikou

Porpodis

Chatzipavlidou

et al. 2019

Technol Cancer Res Treat

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Background: Νeuroendocrine tumors of the lungs are rare arising in the thymus and gastro-entero-pancreatic tract and belonging to foregut of neuroendocrine tumors. The aim of the present prospective study was to estimate the potential impact of single-photon emission computed tomography somatostatin receptor scintigraphy using 99mTc-Tektrotyd on diagnosis, treatment response, and prognosis in patients with neuroendocrine tumors of the lungs. Methods: Thirty-six patients with neuroendocrine tumors of the lungs were evaluated by using 99mTc-HYNIC-TOC scintigraphy. The scintigraphic results were compared to liver tissue uptake (Krenning score). Likewise, the functional imaging results were compared with biochemical indices including chromogranin A, neuroendocrine-specific enolase, and insulin-like growth factor 1 at the time of diagnosis (baseline) and disease progression. Results: The number of somatostatin receptors, expressed with Krenning score, did not show any correlation with the survival of patients both at baseline ( P = .08) and at disease progression ( P = .24), and scintigraphy results did not relate significantly to progression-free survival. Comparing the results of 99mTc-HYNIC-TOC scintigraphy according to the response of patients in the initial treatment, a statistically significant negative correlation was observed both in the first and in the second scintigraphy with patients’ response ( P = .001 and P < .001, respectively). The concentrations of biochemical markers were in accordance with scintigraphy results in the diagnosis. Conclusion: This study indicates that 99mTc-HYNIC-TOC scintigraphy appears to be a reliable, noninvasive technique for detection of primary neuroendocrine tumors and their locoregional or distant metastases, although it cannot be used as a neuroendocrine tumors of the lungs predictive technique.

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Section: Introductionmentioning

confidence: 99%

Predictive Value of 99MTC-hynic-toc Scintigraphy in Lung Neuroendocrine Tumor Diagnosis

Boutsikou

Porpodis

Chatzipavlidou

et al. 2019

Technol Cancer Res Treat

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“…Wider application of hybrid systems (SPECT/CT, SPECT/MRI) as well as new cadmium-zinc-telluride SPECT and SPECT/CT cameras increased and widened application and increased the accuracy of somatostatin receptor scintigraphy[ 33 , 34 ]. These radiopharmaceuticals can also be used for radio-guided surgery thus increasing sensitivity and specificity of the method[ 35 ]. (18 F)-Fluoro-2-deoxy-D-glucose PET/CT is recommended for detecting of low differentiated or heterogeneous neuroendocrine tumors.…”

Section: Discussionmentioning

confidence: 99%

Somatostatin receptor scintigraphy in the follow up of neuroendocrine neoplasms of appendix

Saponjski

Macut

Šobić-Šaranović

et al. 2020

WJCC

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BACKGROUND Neuroendocrine tumors of appendix (ANETs) known as carcinoids, are rare endocrine neoplasms originated from enterochromaffin cells of gastrointestinal tract. ANETs are the third most frequent (16.7%) gastrointestinal neuroendocrine tumors, with the incidence of 0.08-0.2 cases/100000 during one year. Incidental ANETs occur in 0.2%-0.7% of emergency surgical resections because of suspected appendicitis which is usually the first manifestation of ANET. Although there are a lot of papers about application of somatostatin receptor scintigraphy in gastrointestinal neuroendocrine tumors, there are very rare sporadic cases described about ANETs particularly. AIM To establish the role of somatostatin receptor scintigraphy (SRS) in the management of patients with neuroendocrine tumors of appendix (ANET). METHODS The total of 35 patients was investigated, 23 females and 12 males, average age (43.7 ± 17.3 years). All patients had histological diagnosis of ANET (34 carcinoids of appendix and one tubular carcinoid). Majority of tumors have been found incidentally during surgery of: Acute appendicitis ( n = 15), perforated appendicitis ( n = 2), ileus ( n = 3), hysterectomy ( n = 3), ruptured ovarian cyst ( n = 2), caecal volvulus ( n = 1), while 9 patients had diagnosis of appendiceal tumor before the surgery. Seventeen patients had tumor grade (G) G1, 12 G2 and 6 G3. The right hemicolectomy was performed in 13, while the rest of the patients had appendectomy only. SRS was done early (2 h) and late (24 h) after i.v . application of 740 MBq technetium-99m ethylenediamine-N, N'-diacetic acid Hydrazinonicotinyl-Tyr3-Octreotide (technetium-99m-Tektrotyd, Polatom, Poland). SRS was performed for restaging in all the patients after surgery. RESULTS There were 12 true positive (TP), 19 true negative, 3 false positive and 1 false negative SRS result. Sensitivity of the method was 92.31%, specificity was 86.36%, positive predictive value was 80.00%, negative predictive value was 95.00% and accuracy 88.57%. Receiver operating characteristics analysis showed that SRS scintigraphy is a good test for detection TP cases [area under the curve of 0.850, 95% confidence interval (CI): 0.710-0.990, P < 001]. Single photon emission computed tomography contributed diagnosis in 7 TP findings. In 10 patients Krenning score was 4 and in 2 was 3. In 8 patients SRS significantly changed the management of the patients (in two surgery was repeated, in 4 somatostatin analogues and in two peptide receptor radionuclide therapy). Median progression-free survival in SRS positive patients was 52 months (95%CI: 39.7-117.3 mo) while in SRS negative patients it was 60 months (95%CI: 42.8-77.1 mo), without statistically significant differe...

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“…Radioguided surgery in a number of patients with panNETs and other NETs has been reported in a few studies, generally involving small number of patients [186,188,189,192–194]. These include primarily the use of various hand-held detectors after the prior administration of radiolabeled somatostatin analogues, which in some cases identified lesions not otherwise evident.…”

Section: Intraoperative Methods To Localize Pannetsmentioning

confidence: 99%

“…These include primarily the use of various hand-held detectors after the prior administration of radiolabeled somatostatin analogues, which in some cases identified lesions not otherwise evident. [186,188,189,192–194]. This approach has been used successful after 18F-DOPA in patients with medullary thyroid cancer to find additional metastases [195].…”

Section: Intraoperative Methods To Localize Pannetsmentioning

confidence: 99%

Imaging of pancreatic neuroendocrine tumors: recent advances, current status, and controversies

Lee

Ito

Jensen

2018

Expert Review of Anticancer Therapy

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Recently, there have been a number of advances in imaging pancreatic neuroendocrine tumors (panNETs), as well as other neuroendocrine tumors (NETs), which have had a profound effect on the management and treatment of these patients, but in some cases are also associated with controversies. Areas covered: These advances are the result of numerous studies attempting to better define the roles of both cross-sectional imaging, endoscopic ultrasound, with or without fine-needle aspiration, and molecular imaging in both sporadic and inherited panNET syndromes; the increased attempt to develop imaging parameters that correlate with tumor classification or have prognostic value; the rapidly increasing use of molecular imaging in these tumors and the attempt to develop imaging parameters that correlate with treatment/outcome results. Each of these areas and the associated controversies are reviewed. Expert commentary: There have been numerous advances in all aspects of the imaging of panNETs, as well as other NETs, in the last few years. The advances are leading to expanded roles of imaging in the management of these patients and the results being seen in panNETs/GI-NETs with these newer techniques are already being used in more common tumors.

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Radioguided surgery with radiolabeled somatostatin analogs: not only in GEP-NETs

Abstract: Radioguided surgery (RGS) is a surgical technique that, using intra-operative probes, enables the surgeon to identify tissues

Cited by 26 publications

References 70 publications

Predictive Value of 99MTC-hynic-toc Scintigraphy in Lung Neuroendocrine Tumor Diagnosis

Predictive Value of 99MTC-hynic-toc Scintigraphy in Lung Neuroendocrine Tumor Diagnosis

Somatostatin receptor scintigraphy in the follow up of neuroendocrine neoplasms of appendix

Imaging of pancreatic neuroendocrine tumors: recent advances, current status, and controversies

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