The Diagnostic and Grading Accuracy of 68Ga-DOTATATE and 18F-FDG PET/MR for Pancreatic Neuroendocrine Neoplasms

Zhou, Ji; Zhao, Runze; Pan, Yu; Ju, Huijun; Huang, Xin‐Yun; Yu, Jiang; Jin, Jiabin; Zhang, Yifan

doi:10.3389/fonc.2022.796391

Cited by 5 publications

(5 citation statements)

References 34 publications

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“…68 Ga-DOTA-SSA PET/CT is also important for determining radionuclide uptake, which is associated with the response to peptide receptor radionuclide therapy (PRRT) ( 20 ). Research has found that 68 Ga-DOTA-SSA PET/CT can effectively discriminate between low-grade and high-grade pNENs but cannot further differentiate G3 pNETs and pNECs ( 21 ). Due to outstanding diagnostic sensitivity of the 18 F-FDG PET/CT for G3 pNET and pNEC, it is frequently employed in clinical practice in conjunction with 68Ga-DOTA-SSA PET/CT to increase disease diagnostic sensitivity and precise staging ( 22 , 23 ).…”

Section: Discussionmentioning

confidence: 99%

Multivisceral resection of nonfunctional pancreatic neuroendocrine neoplasm with nearby organ invasion: a case report

Zhang,

Niu,

et al. 2023

Front. Endocrinol.

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Pancreatic neuroendocrine neoplasms (pNENs) are relatively rare epithelial malignancies originating from pancreatic neuroendocrine cells, pathologically classified into well-differentiated pancreatic neuroendocrine tumors (pNETs) and poorly-differentiated pancreatic neuroendocrine carcinoma (pNECs). Although they also fall under the category of pNENs, the almost entirely distinct biological characteristics and survival prognosis have caused debate among surgeons when it comes to the development of surgical intervention options, particularly for locally advanced G3 pNETs and pNECs. We present a case of 66-year-old male with nonfunctional G3 pNET, invasion of five nearby pancreatic organs and type II liver metastases. The patient achieved good outcomes after undergoing multivisceral resection and postoperative adjuvant chemotherapy. This finding helps surgeons better understand locally advanced pNENs, formulate treatment decisions systematically and confidently, and balance patient benefits and risks of surgery.

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Section: Discussionmentioning

confidence: 99%

Multivisceral resection of nonfunctional pancreatic neuroendocrine neoplasm with nearby organ invasion: a case report

Zhang,

Niu,

et al. 2023

Front. Endocrinol.

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“…Indeed, SSTR-PET/MRI incorporating hepatobiliary phase imaging is a useful modality in patients with liver dominant NET. However, there is only very little data in NET and PET/MRI available [128,[139][140][141][142][143].…”

Section: Neuroendocrine Tumorsmentioning

confidence: 99%

International EANM-SNMMI-ISMRM consensus recommendation for PET/MRI in oncology

Veit-Haibach,

Ahlström,

Boellaard

et al. 2023

Eur J Nucl Med Mol Imaging

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Preamble The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and professional organization founded in 1954 to promote the science, technology, and practical application of nuclear medicine. The European Association of Nuclear Medicine (EANM) is a professional non-profit medical association that facilitates communication worldwide between individuals pursuing clinical and research excellence in nuclear medicine. The EANM was founded in 1985. The merged International Society for Magnetic Resonance in Medicine (ISMRM) is an international, nonprofit, scientific association whose purpose is to promote communication, research, development, and applications in the field of magnetic resonance in medicine and biology and other related topics and to develop and provide channels and facilities for continuing education in the field.The ISMRM was founded in 1994 through the merger of the Society of Magnetic Resonance in Medicine and the Society of Magnetic Resonance Imaging. SNMMI, ISMRM, and EANM members are physicians, technologists, and scientists specializing in the research and practice of nuclear medicine and/or magnetic resonance imaging. The SNMMI, ISMRM, and EANM will periodically define new guidelines for nuclear medicine practice to help advance the science of nuclear medicine and/or magnetic resonance imaging and to improve the quality of service to patients throughout the world. Existing practice guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated. Each practice guideline, representing a policy statement by the SNMMI/EANM/ISMRM, has undergone a thorough consensus process in which it has been subjected to extensive review. The SNMMI, ISMRM, and EANM recognize that the safe and effective use of diagnostic nuclear medicine imaging and magnetic resonance imaging requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guideline by those entities not providing these services is not authorized. These guidelines are an educational tool designed to assist practitioners in providing appropriate care for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care. For these reasons and those set forth below, the SNMMI, the ISMRM, and the EANM caution against the use of these guidelines in litigation in which the clinical decisions of a practitioner are called into question. The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by the physician or medical physicist in light of all the circumstances presented. Thus, there is no implication that an approach differing from the guidelines, standing alone, is below the standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in the guidelines when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of the guidelines. The practice of medicine includes both the art and the science of the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis or to predict with certainty a particular response to treatment. Therefore, it should be recognized that adherence to these guidelines will not ensure an accurate diagnosis or a successful outcome. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources, and the needs of the patient to deliver effective and safe medical care. The sole purpose of these guidelines is to assist practitioners in achieving this objective.

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“…( Figure 2 ) This allows the use of PET/CT imaging to detect SSTR-expressing PNET with sensitivity of 93% and specificity of 91% [ 24 ]. 68Ga-DOTATATE PET/CT has demonstrated efficacy in the detection of primarily low-grade tumors, G1 and G2 PNETs, with detection rates that have been reported as 95% and 87.5%, respectively [ 25 ]. However, for higher grade tumors (G3), this imaging modality is significantly less effective, with 37.5% detected [ 25 ].…”

Section: Presentation and Diagnosis Of Pancreatic Neuroendocrine Tumorsmentioning

confidence: 99%

“…68Ga-DOTATATE PET/CT has demonstrated efficacy in the detection of primarily low-grade tumors, G1 and G2 PNETs, with detection rates that have been reported as 95% and 87.5%, respectively [ 25 ]. However, for higher grade tumors (G3), this imaging modality is significantly less effective, with 37.5% detected [ 25 ]. An additional work-up should be pursued in patients with high clinical suspicion and negative DOTATATE scan, such as traditional radiolabeled fluorodeoxyglucose (FDG) PET imaging.…”

Section: Presentation and Diagnosis Of Pancreatic Neuroendocrine Tumorsmentioning

confidence: 99%

Surgical Management of Pancreatic Neuroendocrine Tumors

Sulciner

Clancy

2023

Cancers

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Pancreatic neuroendocrine tumors (PNETs) are relatively uncommon malignancies, characterized as either functional or nonfunctional secondary to their secretion of biologically active hormones. A wide range of clinical behavior can be seen, with the primary prognostic indicator being tumor grade as defined by the Ki67 proliferation index and mitotic index. Surgery is the primary treatment modality for PNETs. While functional PNETs should undergo resection for symptom control as well as potential curative intent, nonfunctional PNETs are increasingly managed nonoperatively. There is increasing data to suggest small, nonfunctional PNETs (less than 2 cm) are appropriate follow with nonoperative active surveillance. Evidence supports surgical management of metastatic disease if possible, and occasionally even surgical management of the primary tumor in the setting of widespread metastases. In this review, we highlight the evolving surgical management of local and metastatic PNETs.

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The Diagnostic and Grading Accuracy of 68Ga-DOTATATE and 18F-FDG PET/MR for Pancreatic Neuroendocrine Neoplasms

Cited by 5 publications

References 34 publications

Multivisceral resection of nonfunctional pancreatic neuroendocrine neoplasm with nearby organ invasion: a case report

Multivisceral resection of nonfunctional pancreatic neuroendocrine neoplasm with nearby organ invasion: a case report

International EANM-SNMMI-ISMRM consensus recommendation for PET/MRI in oncology

Surgical Management of Pancreatic Neuroendocrine Tumors

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