Ambrosini V, Tomassetti P, Franchi R, Fanti S
Department of Nuclear Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy.
Q J Nucl Med Mol Imaging. 2010 Feb;54(1):16-23.
Neuroendocrine tumours (NET) diagnosis has represented a major challenge in the past decades. The introduction of somatostatin receptor scintigraphy in the diagnostic work-up led to a significant improvement of accuracy. However with the advent of positron emission tomography (PET) that presents a higher spatial resolution as compared to the gamma camera and an array of different radiotracers, it is now possible to image NET with an even higher accuracy. In fact, PET imaging of NET is a rapidly evolving field closely connected to the development of novel beta-emitting radiopharmaceuticals. NET can be easily visualized on PET scans using an array of both metabolic and receptor-based tracers. [18F]DOPA and [68Ga]DOTA-peptides (DOTA-TOC, DOTA-NOC, DOTA-TATE) are very promising to image well differentiated NET and were reported to be superior to other imaging modalities (computed tomography [CT], somatostatin receptor scintigraphy). On the contrary, the role of [18F]FDG is limited in well differentiated NET, due to their low glucose metabolism and growth rate, while it still can provide valuable information in less differentiated tumours. On-going studies are investigating the potential role of new imaging agents (bombesin, GLP-1, CCK) that specifically bind to receptors expressed on NET cells.
在过去几十年中，神经内分泌肿瘤（NET）的诊断一直是一项重大挑战。在诊断检查中引入生长抑素受体闪烁扫描术使得诊断准确性有了显著提高。然而，随着正电子发射断层扫描（PET）的出现，与伽马相机相比，PET具有更高的空间分辨率以及一系列不同的放射性示踪剂，现在能够以更高的准确性对NET进行成像。事实上，NET的PET成像领域发展迅速，与新型β发射放射性药物的开发紧密相关。使用一系列基于代谢和受体的示踪剂，NET在PET扫描中很容易被可视化。[18F]多巴和[68Ga]多胺多羧基配合物肽（DOTA - TOC、DOTA - NOC、DOTA - TATE）在对高分化NET进行成像方面非常有前景，据报道它们优于其他成像方式（计算机断层扫描[CT]、生长抑素受体闪烁扫描术）。相反，[18F]氟代脱氧葡萄糖（[18F]FDG）在高分化NET中的作用有限，因为它们的葡萄糖代谢和生长速率较低，而在低分化肿瘤中它仍能提供有价值的信息。正在进行的研究正在探究新的成像剂（蛙皮素、胰高血糖素样肽 - 1、胆囊收缩素）的潜在作用，这些成像剂能特异性结合NET细胞上表达的受体。
