论著摘要 |【PET】神经内分泌肿瘤诊断进展(双语版)

2017-09-18 10:23:45 admin 1

Advances in the Diagnosis of Neuroendocrine Neoplasms.

发表日期: 2016.08.23   来源: Seminars in nuclear medicine. WB Saunders, 2016, 46(5): 395-404.

作者

Kulkarni, H. R., Singh, A., Baum, R. P.

作者介绍:

THERANOSTICS Center for Molecular Radiotherapy and Molecular Imaging, ENETS Center of Excellence, Zentralklinik Bad Berka, Bad Berka, Germany

摘要

使用68Ga标记的生长抑素类似物的生长抑素受体PET / CT是评估神经内分泌肿瘤中生长抑素受体状态的主要依据。 此外,18F-FDG PET / CT诊断时葡萄糖代谢评估可以克服组织病理学分级的可能缺点。这为神经内分泌肿瘤的管理提供了系统的治疗方法,即适当治疗手术,生长抑素类似物,肽受体放射性核素治疗,靶向治疗如依维莫司和舒尼替尼或化疗的患者选择,以及治疗反应监测。新型靶标,例如高等级肿瘤中的趋化因子受体CXCR4和胰岛素瘤中的胰高血糖素样肽-1受体似乎有望成像。 -44和铜-64,特别是由于其较长的半衰期(用于预治疗剂量测定)和回旋加速器生产(有利于批量生产),可能是PET / CT成像的68Ga的潜在替代品。 分子成像的未来在于放射学,即与肿瘤基因组学和蛋白质组学相关的肿瘤表型的定性和定量表征,用于个性化的癌症管理。

Abstract

Somatostatin receptor PET/CT using 68Ga-labeled somatostatin analogs, is a mainstay for the evaluation of the somatostatin receptor status in neuroendocrine neoplasms. In addition, the assessment of glucose metabolism by 18F-FDG PET/CT at diagnosis can overcome probable shortcomings of histopathologic grading. This offers a systematic theranostic approach for the management of neuroendocrine neoplasms, that is, patient selection for the appropriate treatment—surgery, somatostatin analogs, peptide receptor radionuclide therapy, targeted therapies like everolimus and sunitinib, or chemotherapy—and also for therapy response monitoring. Novel targets, for example, the chemokine receptor CXCR4 in higher-grade tumors and glucagon like peptide-1 receptor in insulinomas, appear promising for imaging. Scandium-44 and Copper-64, especially on account of their longer half-life (for pretherapeutic dosimetry) and cyclotron production (which favors mass production), might be the potential alternatives to 68Ga for PET/CT imaging. The future of molecular imaging lies in Radiomics, that is, qualitative and quantitative characterization of tumor phenotypes in correlation with tumor genomics and proteomics, for a personalized cancer management. 

 

阅读原文:https://doi.org/10.1053/j.semnuclmed.2016.06.001 

 


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