Visualization of tumor heterogeneity in neuroendocrine tumors by positron emission tomography

  title={Visualization of tumor heterogeneity in neuroendocrine tumors by positron emission tomography},
  author={Constantin Lapa and Rudolf A. Werner and Ken Herrmann},
A 50-year-old woman was diagnosed 15 months ago with a well-differentiated neuroendocrine tumor (NET) of the pancreatic tail (Ki-67: 10 %) and synchronous liver metastases. Consecutively, systemic treatment with octreotide was initiated. Due to progression, 2nd line treatment with peptide receptor radionuclide therapy (PRRT) using the Lu-labeled somatostatin analog DOTA-D-Phe1-Tyr3-octreotide (DOTATOC) was initiated. After three cycles of PRRT, somatostatin receptor (SSTR)-based positron… 
Intraindividual tumor heterogeneity in NET – Further insight by C-X-C motif chemokine receptor 4-directed imaging
This is the first report demonstrating valuable complementary insight into the complexity of tumor heterogeneity by investigation of the CXCR4 expression profile in NET in which receptor overexpression has been described with more aggressive histology.
Survival prediction in patients undergoing radionuclide therapy based on intratumoral somatostatin-receptor heterogeneity
Imaging-based heterogeneity assessment provides prognostic information in PRRT candidates and outperformed conventional PET parameters and can pave the way for individualized patient management.
Molecular imaging reporting and data systems (MI-RADS): a generalizable framework for targeted radiotracers with theranostic implications
A potential future role of the umbrella framework MI-RADS compared to other classification systems is defined and the most common pitfalls on PSMA- and SSTR-targeted PET/CT are discussed.
Clinical and functional implication of the components of somatostatin system in gastroenteropancreatic neuroendocrine tumors
These results provide novel information on SST system pathophysiology in GEP-NETs, including relevant associations with clinical-histological parameters, which might help to better understand the intrinsic heterogeneity of NETs and to identify novel biomarkers and/ or targets with potential prognostic and/or therapeutic value for GEP -NETs patients.
SSTR-RADS Version 1.0 as a Reporting System for SSTR PET Imaging and Selection of Potential PRRT Candidates: A Proposed Standardization Framework
A structured reporting system on a 5-point scale for SSTR PET imaging, titled SSTR-RADS version 1.0, which might serve as a standardized assessment for both diagnosis and treatment planning in neuroendocrine tumors.
Single-cell approaches for molecular classification of endocrine tumors
Single-cell technologies provide an array of powerful new approaches uniquely well suited for dissecting complex endocrine tumors, providing new opportunities to deconstruct the underlying mechanisms of endocrine neoplasia.


Performance of (18)fluorodeoxyglucose-positron emission tomography and somatostatin receptor scintigraphy for high Ki67 (≥10%) well-differentiated endocrine carcinoma staging.
Results suggest that FDG-PET is more sensitive than the SRS for high Ki67 WDEC staging, and a statistical trend was found between Ki67 value and tumor slope.
Prognostic Stratification of Metastatic Gastroenteropancreatic Neuroendocrine Neoplasms by 18F-FDG PET: Feasibility of a Metabolic Grading System
The feasibility of prognostic 3-grade stratification of metastatic gastroenteropancreatic NENs by whole-body molecular imaging using 18F-FDG PET in inoperable multifocal disease is demonstrated.
Can Complementary 68Ga-DOTATATE and 18F-FDG PET/CT Establish the Missing Link Between Histopathology and Therapeutic Approach in Gastroenteropancreatic Neuroendocrine Tumors?
Combined 68Ga-DOTATATE and 18F-FDG PET/CT is helpful in the individual therapeutic approach of GEPNETs and can overcome the shortcomings of histopathologic grading especially in intermediate-grade GEP NETs.
Procedure guidelines for PET/CT tumour imaging with 68Ga-DOTA-conjugated peptides: 68Ga-DOTA-TOC, 68Ga-DOTA-NOC, 68Ga-DOTA-TATE
The aim of these guidelines is to assist nuclear medicine physicians in recommending, performing, reporting and interpreting the results of somatostatin (SST) receptor PET/CT imaging using
Procedure guidelines for PET / CT tumour imaging with 68 GaDOTAconjugated peptides : 68 GaDOTATOC , 68 GaDOTANOC , 68 GaDOTATATE
  • Eur . J . Nucl . Med . Mol . Imaging
  • 2010
  • Eur. J. Nucl. Med. Mol. Imaging 37, 2004–2010
  • 2010