John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Role of nuclear medicine in the treatment of digestive neuroendocrine tumors Volume 24, issue 1, Janvier 2017

Figures

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Authors
1 CHU de Nantes
Institut des Maladies de l’Appareil Digestif
1 place Alexis Ricordeau
44093 Nantes Cedex 1
France
2 CHU-Hôtel Dieu
service de médecine nucléaire
1 place Alexis Ricordeau
44093 Nantes Cedex 1
France
3 CRCNA
INSERM UMR892
8 quai Moncousu
BP 70721
44007 Nantes Cedex
France
4 ICO-Gauducheau
service de médecine nucléaire
Boulevard Jacques Monod
44805 Saint Herblain cedex
France
* Tirés à part

Digestive neuroendocrine tumors (NET) are rare and heterogeneous. Nuclear medicine plays a major role in the diagnostic and prognostic workup of these tumors, but also in their treatment. The use of somatostatin analogues labeled with indium 111 (Octreoscan®) has been the gold standard in the diagnosis of neuroendocrine tumors until recently. However, the new nuclear medicine imaging techniques have been greatly developed. New positon emission tomography (PET) tracers have emerged as potential functional imaging modalities in NETs. The performances of PET using somatostatin analogues labeled with Gallium-68 are higher than those of the Octreoscan®. 18F-FDG provides a prognostic evaluation of NETs. PET using 6-fluoro- (18F) -L-3, 4-dihydroxy-phenylalanine (18F-DOPA) is effective for the diagnosis of NET of serotonergic differentiation, especially of the small intestine. Finally, the peptide receptor radionuclide therapy is now available in France. Results of the Netter-1 study demonstrated the therapeutic efficacy of a somatostatin analogue labeled with Lutetium-177 in NETs derived from the midgut.