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Neuroendocrine Tumors

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Atlas of PET/CT in Pediatric Patients

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Abstract

Neuroendocrine tumors (NETs) are rare neoplasms arising from the diffuse endocrine system and spreading throughout the different organs and tissues of the body. The majority of NETs occurring in the pediatric population are sporadic, but these tumors may also be diagnosed as part of an inherited syndrome, such as multiple endocrine neoplasia (MEN) type I and II, the Carney complex, neurofibromatosis 1 (NF-1), and von Hippel–Lindau (VHL) disease. The use of many radiopharmaceuticals as tracers has been investigated in NET. Dihydroxyphenylalanine labeled with 18F-fluoride (18F-DOPA) is a positron-emitting compound that clinically has been widely used since the early 1980s to image the basal ganglia. In oncology, 18F-DOPA is mostly employed to image tumors arising from neural crest cells and mimicking APUD (amine precursor uptake and decarboxylation) cells in their ability to accumulate and decarboxylate l-DOPA as a precursor of dopamine. The radiopharmaceuticals known as 68Ga-DOTA peptides (-NOC, -TOC, -TATE), include several octreotide analogues, all targeting, with variable affinity, somatostatin receptors. The rationale for using radiolabeled octreotide analogues for imaging NETs is based on the assumption that in more than 80 % of the cases these tumors overexpress somatostatin receptors (SSTRs). Although 18F-fluorodeoxyglucose (18F-FDG) is the tracer of choice for imaging most malignant tumors, its utility in NETs is limited because they exhibit relatively low 18F-FDG uptake, as the vast majority of these tumors are well differentiated.

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Authors and Affiliations

  1. Nuclear Medicine Unit, Humanitas Cancer Center, IRCCS Humanitas, Via Manzoni 56, Rozzano (MI), 20089, Italy

    Egesta Lopci MD

  2. Department of Nuclear Medicine, Positron Emission Tomography Center IRMET S.p.A., Euromedic Inc., Via Onorato Vigliani 89, Turin, 10100, Italy

    Angelina Cistaro MD

  3. Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy

    Angelina Cistaro MD

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  1. Egesta Lopci MD
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  2. Angelina Cistaro MD
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Correspondence to Angelina Cistaro MD .

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  1. Nuclear Medicine, Positron Emission Tomography Centre, Torino, Italy

    Angelina Cistaro

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Lopci, E., Cistaro, A. (2014). Neuroendocrine Tumors. In: Cistaro, A. (eds) Atlas of PET/CT in Pediatric Patients. Springer, Milano. https://doi.org/10.1007/978-88-470-5358-8_11

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  • DOI: https://doi.org/10.1007/978-88-470-5358-8_11

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