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Briganti V, Cuccurullo V, Berti V, Di Stasio GD, Linguanti F, Mungai F, Mansi L. 99mTc-EDDA/HYNIC-TOC is a New Opportunity in Neuroendocrine Tumors of the Lung (and in other Malignant and Benign Pulmonary Diseases). Curr Radiopharm 2020; 13:166-176. [PMID: 31886756 PMCID: PMC8193811 DOI: 10.2174/1874471013666191230143610] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/11/2019] [Accepted: 11/11/2019] [Indexed: 12/25/2022]
Abstract
Neuroendocrine tumors (NETs) consist of a relatively rare spectrum of malignancies that can arise from neuroendocrine cells; lung NETs (L-NETs) represent about 25% of primary lung neoplasm and 10% of all carcinoid tumors. Diagnostic algorithm usually takes into consideration chest Xray, contrast-enhanced CT and MRI. Nuclear medicine plays a crucial role in the detection and correct assessment of neoplastic functional status as it provides in vivo metabolic data related to the overexpression of Somatostatin Receptors (SSTRs) and also predicting response to peptide receptor radionuclide therapy (PRRT). 111In-Pentreotide (Octreoscan®) is commercially available for imaging of neuroendocrine tumors, their metastases and the management of patients with NETs. More recently, 99mTc-EDDA/HYNIC-TOC(Tektrotyd®) was introduced into the market and its use has been approved for imaging of patients with L-NETs and other SSTR-positive tumors. 99mTc-EDDA/HYNIC-TOC could also represent a good alternative to 68Ga-DOTA-peptides (DOTA-TOC, DOTA-NOC, DOTATATE) in hospitals or centers where PET/CT or 68Ge/68Ga generators are not available. When compared to 111In-Pentetreotide, Tektrotyd® showed slightly higher sensitivity, in the presence of higher imaging quality and lower radiation exposure for patients. Interesting perspectives depending on the kinetic analysis allowed by Tektrotyd® may be obtained in differential diagnosis of non-small cells lung cancer (NSCLC) versus small cells lung cancer (SCLC) and NETs. An interesting perspective could be also associated with a surgery radio-guided by Tektrotyd® in operable lung tumors, including either NETs and NSCLC.
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Affiliation(s)
| | - Vincenzo Cuccurullo
- Address correspondence to this author at the Medicina Nucleare, Università della Campania “Luigi Vanvitelli”, P.zza Miraglia 2, 80138 Napoli, Italy; E-mail:
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Cuccurullo V, Di Stasio GD, Mansi L. Physiopathological Premises to Nuclear Medicine Imaging of Pancreatic Neuroendocrine Tumours. Curr Radiopharm 2019; 12:98-106. [DOI: 10.2174/1874471012666190206094555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 02/19/2018] [Accepted: 10/29/2018] [Indexed: 02/07/2023]
Abstract
Background:
Pancreatic Neuroendocrine Tumors (P-NETs) are a challenge in terms of both
diagnosis and therapy; morphological studies need to be frequently implemented with nonstandard
techniques such as Endoscopic Ultrasounds, Dynamic CT, and functional Magnetic Resonance.
Discussion:
The role of nuclear medicine, being scarcely sensitive F-18 Fluorodeoxyglucose, is mainly
based on the over-expression of Somatostatin Receptors (SSTR) on neuroendocrine tumor cells surface.
Therefore, SSTR can be used as a target for both diagnosis, using radiotracers labeled with gamma or
positron emitters, and therapy. SSTRs subtypes are capable of homo and heterodimerization in specific
combinations that alter both the response to ligand activation and receptor internalization.
Conclusion:
Although agonists usually provide efficient internalization, also somatostatin antagonists
(SS-ANTs) could be used for imaging and therapy. Peptide Receptor Radionuclide Therapy (PRRT)
represents the most successful option for targeted therapy. The theranostic model based on SSTR does
not work in insulinoma, in which different radiotracers such as F-18 FluoroDOPA or tracers for the
glucagon-like peptide-1 receptor have to be preferred.
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Affiliation(s)
- Vincenzo Cuccurullo
- Nuclear Medicine Unit, Department of Clinical and Experimental Medicine "F.Magrassi, A.Lanzara" – Universita della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Giuseppe Danilo Di Stasio
- Nuclear Medicine Unit, Department of Clinical and Experimental Medicine "F.Magrassi, A.Lanzara" – Universita della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Luigi Mansi
- Nuclear Medicine Unit, Department of Clinical and Experimental Medicine "F.Magrassi, A.Lanzara" – Universita della Campania "Luigi Vanvitelli", Napoli, Italy
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Ismi O, Arpaci RB, Berkesoglu M, Dag A, Sezer E, Bal KK, Vayısoğlu Y. Calcitonin-negative neuroendocrine tumor of thyroid gland mimicking anaplastic carcinoma: an unusual entity. Gland Surg 2015; 4:344-9. [PMID: 26312221 DOI: 10.3978/j.issn.2227-684x.2015.01.02] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 12/08/2014] [Indexed: 01/14/2023]
Abstract
Medullary thyroid cancer is the neuroendocrine tumor (NET) of thyroid with mostly both secreting calcitonin and immunohistochemically showing calcitonin positivity. Occasionally; NETs of thyroid may have little or no calcitonin expression. We present a case of serum calcitonin negative and immunohistochemically calcitonin-negative staining tumor with positive reaction to neuroendocrine markers synaptophysin and chromogranin-A. The patient's right vocal cord was paralytic and thyroid mass was huge with descending to thorax till hilar region. We discussed diagnostic difficulties and way of treatment about NETs of thyroid with the light of current literature with this case.
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Affiliation(s)
- Onur Ismi
- 1 Department of Otorhinolaryngology, 2 Department of Pathology, Faculty of Medicine, 3 Department of General Surgery, 4 Department of Medical Oncology, Faculty of Medicine, University of Mersin, Mersin, Turkey
| | - Rabia Bozdogan Arpaci
- 1 Department of Otorhinolaryngology, 2 Department of Pathology, Faculty of Medicine, 3 Department of General Surgery, 4 Department of Medical Oncology, Faculty of Medicine, University of Mersin, Mersin, Turkey
| | - Mustafa Berkesoglu
- 1 Department of Otorhinolaryngology, 2 Department of Pathology, Faculty of Medicine, 3 Department of General Surgery, 4 Department of Medical Oncology, Faculty of Medicine, University of Mersin, Mersin, Turkey
| | - Ahmet Dag
- 1 Department of Otorhinolaryngology, 2 Department of Pathology, Faculty of Medicine, 3 Department of General Surgery, 4 Department of Medical Oncology, Faculty of Medicine, University of Mersin, Mersin, Turkey
| | - Emel Sezer
- 1 Department of Otorhinolaryngology, 2 Department of Pathology, Faculty of Medicine, 3 Department of General Surgery, 4 Department of Medical Oncology, Faculty of Medicine, University of Mersin, Mersin, Turkey
| | - Kemal Koray Bal
- 1 Department of Otorhinolaryngology, 2 Department of Pathology, Faculty of Medicine, 3 Department of General Surgery, 4 Department of Medical Oncology, Faculty of Medicine, University of Mersin, Mersin, Turkey
| | - Yusuf Vayısoğlu
- 1 Department of Otorhinolaryngology, 2 Department of Pathology, Faculty of Medicine, 3 Department of General Surgery, 4 Department of Medical Oncology, Faculty of Medicine, University of Mersin, Mersin, Turkey
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Maxwell JE, Howe JR. Imaging in neuroendocrine tumors: an update for the clinician. INTERNATIONAL JOURNAL OF ENDOCRINE ONCOLOGY 2015; 2:159-168. [PMID: 26257863 DOI: 10.2217/ije.14.40] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Neuroendocrine tumors are a heterogeneous group of neoplasms that are best worked up and managed using a variety of clinical and imaging studies. They are often diagnosed after they have already metastasized, though this does not necessarily preclude an attempt at curative surgical treatment or surgical debulking. Tumor burden assessment often requires use of multiple imaging modalities including computed tomography, magnetic resonance imaging and ultrasound. Somatostatin receptor-based imaging is also of great utility in looking for primaries and determining the extent of metastatic disease. This paper will review the most common imaging modalities used in the diagnosis and treatment of neuroendocrine tumors.
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Affiliation(s)
- Jessica E Maxwell
- Department of General Surgery, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
| | - James R Howe
- Department of General Surgery, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
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