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- Title
Functional Imaging in the Follow-Up of Enteropancreatic Neuroendocrine Tumors: Clinical Usefulness and Indications.
- Authors
Merola, Elettra; Pavel, Marianne E; Panzuto, Francesco; Capurso, Gabriele; Cicchese, Noemi; Rinke, Anja; Gress, Thomas M; Iannicelli, Elsa; Prosperi, Daniela; Pizzichini, Patrizia; Prasad, Vikas; Kump, Patrizia; Lipp, Rainer; Partelli, Stefano; Falconi, Massimo; Wiedenmann, Bertram; Delle Fave, Gianfranco
- Abstract
<bold>Context: </bold>Functional imaging tests (FITs) detecting somatostatin receptor expression [i.e., somatostatin receptor scintigraphy, 68Ga-DOTA positron emission tomography/computed tomography (CT)] have a pivotal role in the diagnosis of neuroendocrine tumors (NETs), although their indication during follow-up still needs to be clarified.<bold>Objective: </bold>Investigate the role of FITs after diagnosis of metastatic enteropancreatic NETs, identifying patients who might benefit from these exams.<bold>Design: </bold>Multicenter retrospective analysis of metastatic enteropancreatic NETs.<bold>Setting: </bold>Analysis of imaging tests performed between January 1995 and December 2015 in Rome, Berlin, Milan, Marburg, or Graz.<bold>Subjects: </bold>One hundred forty-three patients with metastatic pancreatic NETs and small intestine NETs, at least 2-year follow-up, and positive FITs.<bold>Interventions: </bold>Patients had received CT every 6 months (unless clinical conditions and tumor behavior required shorter intervals) and FIT every 12 months.<bold>Main Outcome Measures: </bold>Clinical usefulness of FITs, defined as changes in patient management (indication to biopsy, medical therapy, surgery, or further imaging tests) due only to FITs.<bold>Results: </bold>FITs affected management in 73.4% of patients, mostly when G2 vs G1 [odds ratio (OR), 2.40; 95% confidence interval (CI), 1.09 to 5.27; P = 0.03]. Changes were observed in a 12-month time frame especially with pancreatic NETs vs small intestine NETs (OR, 2.89; 95% CI, 1.09 - 7.67; P = 0.03) or metastases since diagnosis vs developed during follow-up (OR, 4.00; 95% CI, 1.43 to 11.17; P < 0.01).<bold>Conclusions: </bold>FITs used in addition to CT in the follow-up of stage IV enteropancreatic NETs improve patient management (especially for G2 tumors). Follow-up program should be tailored according to tumor features.
- Subjects
SMALL intestine; INTESTINAL tumors; LONGITUDINAL method; LYMPH nodes; METASTASIS; NEUROENDOCRINE tumors; ORGANOMETALLIC compounds; PANCREATIC tumors; RADIOPHARMACEUTICALS; PERITONEUM tumors; RETROSPECTIVE studies
- Publication
Journal of Clinical Endocrinology & Metabolism, 2017, pN.PAG
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2016-3732