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The Role of Nuclear Medicine in the Diagnosis of Pancreatic Neuroendocrine Neoplasms

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Pancreatic Neuroendocrine Neoplasms

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Abstract

Nuclear medicine plays an important role in the diagnostic management of pancreatic neuroendocrine tumors (NETs).

Specific radiopharmaceuticals based on the various biological properties of NETs have been developed, both for conventional scintigraphy and positron emission tomography (PET). In the clinical practice, the choice of the most appropriate radiopharmaceutical depends on several factors, including the biologic characteristics of the tumor (somatostatin receptor status, glucose metabolism, amine metabolism), the clinical information needed (diagnostic or prognostic), and practical issues such as availability and costs. For diagnostic purposes, the choice should be guided by tumor differentiation and grading. In well-differentiated NETs (G1 and low G2), functional imaging with radiolabeled peptides should be performed for lesion identification; in this context, 68Ga-DOTA-peptide PET/CT is considered the nuclear medicine technique of choice. 111In-DTPA-octreotide (OctreoScan®) SPECT/CT should be considered obsolete for diagnostic purposes and maintains a role only for evaluating the receptor status prior to therapy. 18F-FDG is the tracer of choice for imaging poorly differentiated NETs (high G2 and G3), where a loss of NET features is expected, and to obtain prognostic information, since the presence of 18F-FDG-positive lesions correlates with a poor prognosis independently from tumor grading. Other radiopharmaceuticals with a more limited use in pancreatic NETs, i.e., 18F-DOPA and 11C-5-HTP, are also shortly discussed.

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Authors and Affiliations

  1. Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, Rome, 00168, Italy

    Vittoria Rufini, Paola Castaldi & Valerio Lanni

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  1. Vittoria Rufini
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  2. Paola Castaldi
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  3. Valerio Lanni
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Correspondence to Vittoria Rufini .

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Editors and Affiliations

  1. Department of Pathology, Ospedale di Circolo, Varese, Italy

    Stefano La Rosa

  2. Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy

    Fausto Sessa

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Rufini, V., Castaldi, P., Lanni, V. (2015). The Role of Nuclear Medicine in the Diagnosis of Pancreatic Neuroendocrine Neoplasms. In: La Rosa, S., Sessa, F. (eds) Pancreatic Neuroendocrine Neoplasms. Springer, Cham. https://doi.org/10.1007/978-3-319-17235-4_3

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  • DOI: https://doi.org/10.1007/978-3-319-17235-4_3

  • Publisher Name: Springer, Cham

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