Neuroendocrine tumors (NET) are a heterogeneous group of tumours that originate from the neural crest. These tumors are characterized by their ability to overexpress somatostatin (SST) receptorsin most cells deriving from so-called neuroendocrine dispersed cells. The main primary sites are the gastrointestinal tract and the lung, but NET can also originate from various other sites, such as the head and neck or the prostate.
Nuclear Medicine imaging with Indium-111 CCT analogue (Octreotide) has been proven successful. However, it lacks spatial resolution and is a time consuming methodology. F-18 FDG PET scanning is another widely accepted imaging approach in clinical oncology. Although F-18 FDG PET has high spatial resolution,unlike for many other malignancies, it is not indicated primarily for NET because of its poor sensitivity to detect tumors with low metabolic activity and slow growth.Contrast-enhanced multidetector
CT provides higher image resolution and gives information about the vascular phase for detection of even small-sized lesions of neuroendocrine origin. However, this sometimes lack specificity, as conclusions regarding malignant involvement of organ structures are based only on size criteria and the contrast enhancement pattern.
PET imaging using Gallium-68 (Ga-68) labeled compound -DOTATATE offers higher resolution and improved pharmacokinetcs compared with SRS, with promising results in the detection of SST receptor-expressing tumors. This is combined with contrast enhanced multi detector CT images. Currently this technology is available at our centre only in the region, making it a Regional Centre for imaging of the neuroendocrine tumours.
