Somatostatin receptor-based imaging and therapy of gastroenteropancreatic neuroendocrine tumors

Abstract

Somatostatin receptor imaging (SRI) with [ 111 ]octreotide has proven its role in the diagnosis and staging of gastroenteropancreatic neuroendocrine tumors (GEPNETs). Newer radiolabeled somatostatin analogs which can be used in positron emission tomography (PET) imaging, and which have a higher affinity for the somatostatin receptor, especially receptor subtype-2, have been developed. It would be desirable, however, if one radiolabeled analog became the new standard for PET imaging, because the current application of a multitude of analogs implies a fragmented knowledge on the interpretation of the images that are obtained in clinical practice. In our view, the most likely candidates for such a universal PET

Effect of calculation method on kidney dosimetry in 177Lu-octreotate treatment

“…The main indication is locally advanced or metastatic gastroenteropancreatic NET overexpressing somatostatin receptors upon imaging for somatostatin receptors [2,3]. The activity range of 177 Lu-octreotate usually given is 5.5-7.4 GBq at eight-week intervals [4][5][6][7]. It is common to give four treatments with the possibility of retreatment later on in progression.…”

Neuroendocrine tumor disease: an evolving landscape

“…These drawbacks have, to some extent, been overcome by the introduction of newer SSAs such as DOTA-D-Phe 1 -Try 3 -octreotide (DOTATOC), DOTA-D-Phe 1 -Try 3 -octreotate (DOTATAE), and DOTA-1-NaI Try 3 -octreotide (DOTANOC), which exhibit not only a higher sstr 2 affinity but also affinity to sstr 3 and sstr 5 (DOTANOC). Optimization of the profile is achieved when labeled with a generatorderived positron emitter such as 68 Ga, which is suitable for positron emission tomography (PET) imaging (Kwekkeboom et al 2010). Precise fusion of functional PET images with a morphological image tools such as CT (PET/CT) has provided additional anatomical information with regard to localization of lesions and definition of lesion boundaries with the added benefit of CT-based attenuation correction of the emission results (Fig.…”

Medical imaging in personalised medicine: a white paper of the research committee of the European Society of Radiology (ESR)

“…The simplest version of this is 18 F-fluorodeoxyglucose ( 18 FDG) imaging (Fig. 3), which assesses the glucose uptake and thus the metabolic activity level of various cancers [7], but more specific probes can and are being developed for individual types of cancer [36]. "One can foresee the further expansion of PET imaging-based personalised management of cancer, which, based on the strong evidence generated through a number of clinical studies and by its ability to monitor disease activity at the individual level, is likely to be increasingly integrated into the standard evidence-based clinical practice of oncology" [22].…”