The Status of Neuroendocrine Tumor Imaging: From Darkness to Light?

• Published in: Neuroendocrinology Vol. 101; no. 1; pp. 1 - 17
• Main Authors: Bodei, Lisa, Sundin, Anders, Kidd, Mark, Prasad, Vikas, Modlin, Irvin M.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2015
• Subjects: At the Cutting Edge; CT imaging; Diagnostic imaging; Diagnostic Imaging - methods; Humans; Methods; Neuroendocrine Tumors - diagnosis; Reproducibility of Results; Sensitivity and Specificity; United States; Scintigraphy; Computed tomography; Magnetic resonance imaging; Positron emission tomography; Imaging; Neuroendocrine tumors
• ISSN: 0028-3835; 1423-0194; 1423-0194
• DOI: 10.1159/000367850

Diagnostic imaging plays a pivotal role in the diagnosis, staging, treatment selection and follow-up for neuroendocrine tumors. The available diagnostic strategies are morphologic imaging, including computed tomography, magnetic resonance imaging (MRI) and ultrasound techniques, and molecular imaging, including scintigraphy with 111 In-pentetreotide and positron emission tomography with 68 Ga-DOTA-peptides, 18 F-DOPA and 11 C-5-HTP. A combination of anatomic and functional techniques is routinely performed to optimize sensitivity and specificity. The introduction of diffusion-weighted MRI and dynamic contrast-enhanced techniques represents a promising advance in radiologic imaging, whereas new receptor-binding peptides, including somatostatin agonists and antagonists, represent the recent most favorable innovation in molecular imaging. Future development includes the short-term validation of these techniques, but in extension also a more comprehensive multilevel integration of biologic information pertaining to a specific tumor and patient, possibly encompassing genomic considerations, currently evolving as a new entity denoted ‘precision medicine'. The ideal is a diagnostic sequence that captures the global status of an individual's tumor and encompasses a multidimensional characterization of tumor location, metabolic performance and target identification. To date, advances in imagery have focused on increasing resolution, discrimination and functional characterization. In the future, the fusion of imagery with the parallel analysis of biological and genomic information has the potential to considerably amplify diagnosis.