Functional Imaging in the Follow-Up of Enteropancreatic Neuroendocrine Tumors: Clinical Usefulness and Indications

Functional imaging tests (FITs) detecting somatostatin receptor expression [i.e., somatostatin receptor scintigraphy, 68Ga-DOTA positron emission tomography/computed tomography (CT)] have a pivotal role in the diagnosis of neuroendocrine tumors (NETs), although their indication during follow-up stil...

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Veröffentlicht in:The journal of clinical endocrinology and metabolism Jg. 102; H. 5; S. 1486 - 1494
Hauptverfasser: Merola, Elettra, Pavel, Marianne E., Panzuto, Francesco, Capurso, Gabriele, Cicchese, Noemi, Rinke, Anja, Gress, Thomas M., Iannicelli, Elsa, Prosperi, Daniela, Pizzichini, Patrizia, Prasad, Vikas, Kump, Patrizia, Lipp, Rainer, Partelli, Stefano, Falconi, Massimo, Wiedenmann, Bertram, Delle Fave, Gianfranco
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Oxford University Press 01.05.2017
Schlagworte:
Adult
Aged
Biopsy
Computed tomography
Diagnosis
Disease management
Female
Follow-Up Studies
Humans
Intestinal Neoplasms - diagnostic imaging
Intestinal Neoplasms - pathology
Intestine, Small - diagnostic imaging
Lymph Nodes - diagnostic imaging
Lymph Nodes - pathology
Male
Medical imaging
Metastases
Metastasis
Middle Aged
Neoplasm Metastasis
Neuroendocrine tumors
Neuroendocrine Tumors - diagnostic imaging
Neuroendocrine Tumors - secondary
Organometallic Compounds
Pancreas
Pancreatic Neoplasms - diagnostic imaging
Pancreatic Neoplasms - pathology
Patients
Peritoneal Neoplasms - diagnostic imaging
Peritoneal Neoplasms - secondary
Positron emission tomography
Positron Emission Tomography Computed Tomography
Radiopharmaceuticals
Retrospective Studies
Scintigraphy
Small intestine
Somatostatin
Surgery
Tomography
Tumors
ISSN:0021-972X, 1945-7197, 1945-7197
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Zusammenfassung:Functional imaging tests (FITs) detecting somatostatin receptor expression [i.e., somatostatin receptor scintigraphy, 68Ga-DOTA positron emission tomography/computed tomography (CT)] have a pivotal role in the diagnosis of neuroendocrine tumors (NETs), although their indication during follow-up still needs to be clarified. Investigate the role of FITs after diagnosis of metastatic enteropancreatic NETs, identifying patients who might benefit from these exams. Multicenter retrospective analysis of metastatic enteropancreatic NETs. Analysis of imaging tests performed between January 1995 and December 2015 in Rome, Berlin, Milan, Marburg, or Graz. One hundred forty-three patients with metastatic pancreatic NETs and small intestine NETs, at least 2-year follow-up, and positive FITs. Patients had received CT every 6 months (unless clinical conditions and tumor behavior required shorter intervals) and FIT every 12 months. Clinical usefulness of FITs, defined as changes in patient management (indication to biopsy, medical therapy, surgery, or further imaging tests) due only to FITs. FITs affected management in 73.4% of patients, mostly when G2 vs G1 [odds ratio (OR), 2.40; 95% confidence interval (CI), 1.09 to 5.27; P = 0.03]. Changes were observed in a 12-month time frame especially with pancreatic NETs vs small intestine NETs (OR, 2.89; 95% CI, 1.09 - 7.67; P = 0.03) or metastases since diagnosis vs developed during follow-up (OR, 4.00; 95% CI, 1.43 to 11.17; P < 0.01). FITs used in addition to CT in the follow-up of stage IV enteropancreatic NETs improve patient management (especially for G2 tumors). Follow-up program should be tailored according to tumor features.
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ISSN:0021-972X
1945-7197
1945-7197
DOI:10.1210/jc.2016-3732