Neuroendocrine Tumors of the Abdomen: Imaging and Therapy

  • Dik J. Kwekkeboom


The development of peptide receptor scintigraphy in combination with radioiodinated somatostatin analogues allowed the in vivo demonstration of somatostatin-receptorpositive tumors in patients [1]. Later, other radiolabeled somatostatin analogues were developed, two of which subsequently became commercially available. With the advent, over the past decade, of positron emission tomography (PET) tracers for somatostatin receptor imaging, superior image quality and increased sensitivity in tumor site detection have become possible, as confirmed by several research groups. In the 1990’s, attempts at treatment with radiolabeled somatostatin analogues were undertaken in patients with inoperable and/or metastasized neuroendocrine tumors. Improvements in the peptides (higher receptor affinity) and the available radionuclides (β instead of γ emission), together with precautions to limit the radiation dose to the kidneys and bone marrow, led to better results and a virtually negligible percentage of serious adverse events.


Single Photon Emission Compute Tomography Neuroendocrine Tumor Peptide Receptor Radionuclide Therapy Octreotide Scintigraphy Peptide Receptor Scintigraphy 
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  1. 1.
    Krenning EP, Bakker WH, Breeman WA et al (1989) Localization of endocrine related tumors with radioiodinated analogue of somatostatin. Lancet 1:242–245CrossRefPubMedGoogle Scholar
  2. 2.
    Balon HR, Goldsmith SJ, Siegel BA et al (2001) Procedure guideline for somatostatin receptor scintigraphy with 111Inpentetreotide. J Nucl Med 42:1134–1138PubMedGoogle Scholar
  3. 3.
    Gibril F, Reynolds JC, Chen CC et al (1999) Specificity of somatostatin receptor scintigraphy: a prospective study and effects of false-positive localizations on management in patients with gastrinomas. J Nucl Med 40:539–553PubMedGoogle Scholar
  4. 4.
    Reubi JC (1997) Regulatory peptide receptors as molecular targets for cancer diagnosis and therapy. Q J Nucl Med 41:63–70PubMedGoogle Scholar
  5. 5.
    Reubi JC, Waser B, Schaer JC, Laissue JA (2001) Somatostatin receptor sst1–sst5 expression in normal and neoplastic human tissues using receptor autoradiography with subtypeselective ligands. Eur J Nucl Med 28:836–846CrossRefPubMedGoogle Scholar
  6. 6.
    Reubi JC, Waser B, Krenning EP et al (1994) Vascular somatostatin receptors in synovium from patients with rheumatoid arthritis. Eur J Pharmacol 271:371–378CrossRefPubMedGoogle Scholar
  7. 7.
    Krenning EP, Kwekkeboom DJ, Bakker WH et al (1993) Somatostatin receptor scintigraphy with [111In-DTPA-D-Phe1]-and [123I-Tyr3]-octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med 20:716–731CrossRefPubMedGoogle Scholar
  8. 8.
    Kwekkeboom DJ, Krenning EP, Bakker WH et al (1993) Somatostatin analogue scintigraphy in carcinoid tumors. Eur J Nucl Med 20:283–292CrossRefPubMedGoogle Scholar
  9. 9.
    Westlin JE, Janson ET, Arnberg H et al (1993) Somatostatin receptor scintigraphy of carcinoid tumours using the [111In DTPA D Phe1] octreotide. Acta Oncol 32:783–786CrossRefPubMedGoogle Scholar
  10. 10.
    De Kerviler E, Cadiot G, Lebtahi R et al (1994) Somatostatin receptor scintigraphy in forty eight patients with the Zollinger Ellison syndrome. Eur J Nucl Med 21:1191–1197CrossRefPubMedGoogle Scholar
  11. 11.
    Gibril F, Reynolds JC, Doppman JL et al (1996) Somatostatin receptor scintigraphy: its sensitivity compared with that of other imaging methods in detecting primary and metastatic gastrinomas. A prospective study. Ann Intern Med 125:26–34PubMedGoogle Scholar
  12. 12.
    Lebtahi R, Cadiot G, Sarda L et al (1997) Clinical impact of somatostatin receptor scintigraphy in the management of patients with neuroendocrine gastroenteropancreatic tumors. J Nucl Med 38:853–858PubMedGoogle Scholar
  13. 13.
    Menda Y, Kahn D (2002) Somatostatin receptor imaging of nonsmall lung cancer with 99mTc depreotide. Semin Nucl Med 32:92–96CrossRefPubMedGoogle Scholar
  14. 14.
    Lebtahi R, Le Cloirec J, Houzard C et al (2002) Detection of Neuroendocrine Tumors: (99m)Tc-P829 Scintigraphy Compared with (111)In-Pentetreotide Scintigraphy. J Nucl Med 43:889–895PubMedGoogle Scholar
  15. 15.
    Hofmann M, Maecke H, Börner R et al (2001) Biokinetics and imaging with the somatostatin receptor PET radioligand (68)Ga-DOTATOC: preliminary data. Eur J Nucl Med 28:1751–1757CrossRefPubMedGoogle Scholar
  16. 16.
    Quigley AM, Buscombe JR, Shah T et al (2005) Intertumoural variability in functional imaging within patients suffering from neuroendocrine tumours. An observational, cross-sectional study. Neuroendocrinology 82:215–220CrossRefPubMedGoogle Scholar
  17. 17.
    Belhocine T, Foidart J, Rigo P et al (2002) Fluorodeoxyglucose positron emission tomography and somatostatin receptor scintigraphy for diagnosing and staging carcinoid tumours: correlations with the pathological indexes p53 and Ki-67. Nucl Med Commun 23:727–734CrossRefPubMedGoogle Scholar
  18. 18.
    Koopmans KP, de Vries EG, Kema IP et al (2006) Staging of carcinoid tumours with 18F-DOPA PET: a prospective, diagnostic accuracy study. Lancet Oncol 7:728–734CrossRefPubMedGoogle Scholar
  19. 19.
    Arnold R, Benning R, Neuhaus C et al (1993) Gastroenteropancreatic endocrine tumours: effect of Sandostatin on tumour growth. The German Sandostatin Study Group. Digestion 54(Suppl 1):72–75CrossRefPubMedGoogle Scholar
  20. 20.
    Valkema R, de Jong M, Bakker WH et al (2002) Phase I study of peptide receptor radionuclide theraply with [111In-DTPA0] Octreotide: the Rotterdam experience. Semin Nucl Med 32:110–122CrossRefPubMedGoogle Scholar
  21. 21.
    Anthony LB, Woltering EA, Espanan GD et al (2002) Indium-111-pentetreotide prolongs survival in gastroenteropancreatic malignancies. Semin Nucl Med 32:123–132CrossRefPubMedGoogle Scholar
  22. 22.
    Bodei L, Cremonesi M, Zoboli S et al (2003) Receptor-mediated radionuclide therapy with 90Y-DOTATOC in association with amino acid infusion: a phase I study. Eur J Nucl Med Mol Imag 30:207–216CrossRefGoogle Scholar
  23. 23.
    Waldherr C, Pless M, Maecke HR et al (2001) The clinical value of [90Y-DOTA]-D-Phe1-Tyr3-octreotide (90Y-DOTATOC) in the treatment of neuroendocrine tumours: a clinical phase II study. Ann Oncol 12:941–945CrossRefPubMedGoogle Scholar
  24. 24.
    Waldherr C, Pless M, Maecke HR et al (2002) Tumor response and clinical benefit in neuroendocrine tumors after 7.4 GBq (90)Y-DOTATOC. J Nucl Med 43:610–616PubMedGoogle Scholar
  25. 25.
    Valkema R, Pauwels S, Kvols LK et al (2006) Survival and response after peptide receptor radionuclide therapy with [90YDOTA0, Tyr3]octreotide in patients with advanced gastroenteropancreatic neuroendocrine tumors. Semin Nucl Med 36:147–156CrossRefPubMedGoogle Scholar
  26. 26.
    Valkema R, Pauwels SA, Kvols LK et al (2005) Long-term follow-up of renal function after peptide receptor radiation therapy with 90Y-DOTA0,Tyr3-octreotide and 177Lu-DOTA0, Tyr3-octreotate. J Nucl Med 46(Suppl 1):83S–91SPubMedGoogle Scholar
  27. 27.
    Reubi JC, Schaer JC, Waser B et al (2000) Affinity profiles for human somatostatin receptor sst1-sst5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med 27:273–282CrossRefPubMedGoogle Scholar
  28. 28.
    Kwekkeboom DJ, Bakker WH, Kooij PP et al (2001) [177Lu-DOTA0Tyr3]octreotate: comparison with [111In-DTPA0]octreotide in patients. Eur J Nucl Med 28:1319–1325CrossRefPubMedGoogle Scholar
  29. 29.
    Kwekkeboom DJ, de Herder WW, Kam BL et al (2008) Treatment with the radiolabeled somatostatin analog [177Lu-DOTA0,Tyr3]octreotate: toxicity, efficacy, and survival. J Clin Oncol 26:2124–2130CrossRefPubMedGoogle Scholar
  30. 30.
    De Keizer B, van Aken MO, Feelders RA et al (2008) Hormonal crises following receptor radionuclide therapy with the radiolabeled somatostatin analogue [177Lu-DOTA0,Tyr3] octreotate. Eur J Nucl Med Mol Imag 35:749–755CrossRefGoogle Scholar

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© Springer Verlag Italia 2010

Authors and Affiliations

  • Dik J. Kwekkeboom
    • 1
  1. 1.Department of Nuclear MedicineErasmus Medical CenterRotterdamThe Netherlands

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