The role of combined FDG and SST PET/CT in neuroendocrine tumors.

IF 3.3 4区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Neuroendocrinology Pub Date : 2024-11-22 DOI:10.1111/jne.13474

Martina Di Franco, Emilia Fortunati, Lucia Zanoni, Stefano Fanti, Valentina Ambrosini

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引用次数: 0

Abstract

Somatostatin receptor (SST) positron emission tomography with computed tomography (PET/CT) is the gold standard for functional imaging of neuroendocrine tumors (NETs), but FDG PET/CT is increasingly recognized for its prognostic value, particularly for higher-grade NETs and to detect disease heterogeneity. Despite the established role of pathological grading, clinical heterogeneity within the tumor burden often complicates accurate prognostication. Evidence suggests FDG PET/CT can outperform WHO grading in predicting outcomes by identifying aggressive, undifferentiated tumor clones that influence long-term prognosis and treatment decisions. Several grading systems integrating both SST and FDG PET/CT have been proposed to better capture tumor heterogeneity and guide clinical management. Studies demonstrate that FDG PET/CT can influence management in a significant subset of patients, although variably reported. Its use remains variable across centers, also affected by different reimbursement policies and local clinical practices. This review explores the indications to FDG PET/CT in NET and the clinical impact of combined SST and FDG PET/CT imaging.

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联合 FDG 和 SST PET/CT 在神经内分泌肿瘤中的作用。

体生长抑素受体（SST）正电子发射计算机断层扫描（PET/CT）是神经内分泌肿瘤（NET）功能成像的金标准，但FDG PET/CT的预后价值也日益得到认可，尤其是对高级别NET和检测疾病异质性方面。尽管病理分级的作用已经确立，但肿瘤内的临床异质性往往使准确的预后判断变得复杂。有证据表明，FDG PET/CT 在预测预后方面优于 WHO 分级，因为它能识别影响长期预后和治疗决策的侵袭性未分化肿瘤克隆。为了更好地捕捉肿瘤的异质性并指导临床治疗，人们提出了几种整合了 SST 和 FDG PET/CT 的分级系统。研究表明，FDG PET/CT 可对相当一部分患者的治疗产生影响，但报道不一。不同中心的使用情况仍不尽相同，还受到不同报销政策和当地临床实践的影响。本综述探讨了 FDG PET/CT 在 NET 中的适应症以及 SST 和 FDG PET/CT 联合成像的临床影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuroendocrinology 医学-内分泌学与代谢

CiteScore

6.40

自引率

6.20%

发文量

137

审稿时长

4-8 weeks

期刊介绍： Journal of Neuroendocrinology provides the principal international focus for the newest ideas in classical neuroendocrinology and its expanding interface with the regulation of behavioural, cognitive, developmental, degenerative and metabolic processes. Through the rapid publication of original manuscripts and provocative review articles, it provides essential reading for basic scientists and clinicians researching in this rapidly expanding field. In determining content, the primary considerations are excellence, relevance and novelty. While Journal of Neuroendocrinology reflects the broad scientific and clinical interests of the BSN membership, the editorial team, led by Professor Julian Mercer, ensures that the journal’s ethos, authorship, content and purpose are those expected of a leading international publication.