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Review
. 2021 Nov 4;23(12):143.
doi: 10.1007/s11912-021-01139-2.

New Directions in Imaging Neuroendocrine Neoplasms

Julie Refardt  1   2   3 , Johannes Hofland  1 , Damian Wild  2   4 , Emanuel Christ  5   6
Affiliations
Review

New Directions in Imaging Neuroendocrine Neoplasms

Julie Refardt et al. Curr Oncol Rep. .

Abstract

Purpose of review: Accurate imaging is crucial for correct diagnosis, staging, and therapy of neuroendocrine neoplasms (NENs). The search for the optimal imaging technique has triggered rapid development in the field. This review aims at giving an overview on contemporary imaging methods and providing an outlook on current progresses.

Recent findings: The discovery of molecular targets due to the overexpression of specific peptide hormone receptors on the NEN's surface has triggered the development of multiple radionuclide imaging modalities. In addition to the established imaging technique of targeting somatostatin receptors, several alternative radioligands have been developed. Targeting the glucagon-like peptide-1 receptor by exendin-4 has a high sensitivity in localizing insulinomas. For dedifferentiated NENs, new molecular targets such as the C-X-C motif chemokine-receptor-4 have been evaluated. Other new targets involve the fibroblast activation protein and the cholecystokinin-2 receptors, where the ligand minigastrin opens new possibilities for the management of medullary thyroid carcinoma. Molecular imaging is an emerging field that improves the management of NENs.

Keywords: CCK2-receptor imaging; GLP-1 receptor imaging; Neuroendocrine neoplasms; Peptide hormone receptors; Somatostatin receptor antagonist.

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Conflict of interest statement

Julie Refardt declares that she has no conflict of interest. Johannes Hofland has received compensation from Ipsen and Novartis for service as a consultant. Damian Wild declares that he has no conflict of interest. Emanuel Christ declares that he has no conflict of interest.

Figures

Fig. 1
Fig. 1
Overview of currently used molecular targets for imaging of NENs. CCK2-R = cholecystokinin-2 receptor, CXCR4 = C-X-C motif chemokine-receptor-4, FAP = fibroblast activation protein, FDG = fluorodeoxyglucose, F-DOPA = fluoro-dopa, GLP1R = GLP-1-receptor, MIBG = metaiodobenzygluanidine, NEN = neuroendocrine neoplasm, SSTR = somatostatin receptor
Fig. 2
Fig. 2
Targeting of GLP-1R with 68Ga-DOTA-exendin-4 PET/CT. Patient with biochemically confirmed endogenous hyperinsulinemic hypoglycemia. CT and MRI were negative. Coronal (A) and transaxial (B) PET/CT showed focal 68Ga-DOTA-exendin-4 uptake in the body of the pancreas (white arrows) consistent with a benign insulinoma. Coronal (C) and transaxial (D) T1-weighted MRI showed a slightly hypointense signal at the same location (white arrows) and was only retrospectively interpreted as a suspicious lesion. Histology confirmed an insulinoma in the pancreatic body
See this image and copyright information in PMC

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