Title:Molecular and Metabolic Imaging of Hepatic Neuroendocrine Tumors Following Radioembolization with 90Y-microspheres
Volume: 16
Author(s): Luca Filippi*, Roberto Cianni, Orazio Schillaci and Oreste Bagni
Affiliation:
- Department of Nuclear Medicine, Santa Maria Goretti Hospital, Via Canova 3, Latina 04100,Italy
Keywords:
Neuroendocrine tumors, radioembolization, 90Y-microspheres, PET, SPECT, FDG.
Abstract: Liver is the predominant site of metastatization for neuroendocrine tumors (NETs). Up
to 75% of patients affected by intestinal NETs present liver metastases at diagnosis. For hepatic
NET, surgery represents the most effective approach but is often unfeasible due to the massive involvement
of multifocal disease. In such cases, chemotherapy, peptide receptor radionuclide therapy
and loco-regional treatments may represent alternative therapeutic options. In particular,
radioembolization with 90Y-microspheres has been introduced as a novel technique for treating
hepatic malignant lesions, combining the principles of embolization and radiation therapy. In order
to evaluate the response to 90Y-radioembolization, standard radiologic criteria have been demonstrated
to present several limitations. 18Fluoro-deoxyglucose (FDG) Positron Emission Tomography
(PET) is routinely used for monitoring the response to therapy in oncology. Nevertheless,
NETs often present low glycolytic activity thus the conventional 18FDG PET may not be adequate
for these tumors. For many years, somatostatin receptor scintigraphy (SRS) with 111In-pentetreotide
has been used for diagnosis and staging of NETs. More recently, three 68Ga-DOTA-compounds
have been developed and introduced for the imaging of NETs with PET technology. The aim of the
present paper was to review the existing literature concerning the application of different metabolic
and molecular probes for the imaging evaluation of hepatic NETs following 90Y-RE.
