Open AccessDual tracer hybrid radionuclide imaging of a metastatic gastrointestinal neuroendocrine tumor with unknown primary site using 18F-FDG PET/CT and 99mTc-HYNIC-TOC SPECT/CT (case report and literature review)
Author(s) -
А. В. Леонтьев,
Н. А. Рубцова,
А. И. Халимон,
Т. Л. Антоневская,
М. Т. Кулиев,
А. В. Левшакова,
И. В. Пылова,
Т. Н. Лазутина,
А. Д. Каприн
Publication year - 2021
Publication title -
medicinskaâ vizualizaciâ
Language(s) - English
Resource type - Journals
eISSN - 2408-9516
pISSN - 1607-0763
DOI - 10.24835/1607-0763-927
Subject(s) - neuroendocrine tumors , somatostatin receptor , medicine , nuclear medicine , pet ct , radionuclide therapy , positron emission tomography , somatostatin , radiation treatment planning , spect imaging , primary tumor , molecular imaging , functional imaging , lesion , radiology , metastasis , pathology , cancer , in vivo , radiation therapy , biology , microbiology and biotechnology
Neuroendocrine tumors (NEТ) are a heterogeneous group of neoplasms of various locations originating from the APUD system cells with biologically active properties. Although immunohistochemical assay for Ki-67 has been proved to have prognostic significance in GEP-NENs, pitfalls may lead to misjudgment of the tumor grades, prognosis and during treatment planning due to the presence of cells with varying degrees of differentiation and proliferative activity within a single lesion, as well as the entire neoplastic process. These features can affect the results of imaging and therapy planning. An increase in the number of somatostatin receptors on the surface of membrane cells, as well as an increase in glycolysis may occur in NETs. These phenomena play role when choosing imaging methods, as well as in treatment planning. Combined dual-tracer imaging, specifically PET/CT or SPECT/CT using labeled somatostatin analogues can be used in intermediate assessment of cellular heterogeneity in the entire neoplastic process in NENs and help to minimize diagnostic pitfalls listed above. We present an observation of a patient with metastatic GEP-NEN of unknown primary in which 18 F-FDG PET/CT and 99m Tc-HYNIC-TOC SPECT/CT were performed for initial staging. In the framework of this, aspects of use of dual-tracer radionuclide imaging in patients with NENs are widely discussed.