Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, 00189, Rome, Italy.
Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy.
Endocrine. 2022 May;76(2):484-490. doi: 10.1007/s12020-022-03000-3. Epub 2022 Feb 11.
Since the role of [F]FDG PET/CT in low-grade gastroenteropancreatic (GEP) neuroendocrine neoplasia (NET) is not well established, this study was aimed to evaluate the role of [F]FDG PET/CT in grade 1 (G1) GEP-NETs.
This is a retrospective study including patients with G1 GEP-NETs who underwent [F]FDG PET/CT.
55 patients were evaluated, including 24 (43.6%) with pancreatic NETs and 31 (56.4%) with gastrointestinal NETs. At the time of diagnosis, 28 (51%) patients had metastatic disease, and 50 (91%) patients were positive by 68-Ga sstr PET/CT. Overall, 27 patients (49%) had positive findings on [F]FDG PET/CT. Following [F]FDG PET/CT, therapeutic management was modified in 29 (52.7%) patients. Progression-free survival was longer in patients with negative [F]FDG PET/CT compared with positive [F]FDG PET/CT (median PFS was not reached and 24 months, respectively, p = 0.04). This significance was particularly evident in the pancreatic group (p = 0.008).
Despite having low proliferative activity, approximately half of GEP-NETs G1 showed positive [F]FDG PET/CT, with a corresponding negative impact on patients' clinical outcomes. These data are in favor of a more "open" attitude toward the potential use of [F]FDG PET/CT in the diagnostic work-up of G1 GEP-NETs, which may be used in selected cases to detect those at higher risk for an unfavorable disease course.
由于 [F]FDG PET/CT 在低级别胃肠胰腺（GEP）神经内分泌肿瘤（NET）中的作用尚未明确，本研究旨在评估 [F]FDG PET/CT 在 1 级（G1）GEP-NET 中的作用。
这是一项回顾性研究，纳入了接受 [F]FDG PET/CT 检查的 G1 GEP-NET 患者。
共评估了 55 例患者，其中 24 例（43.6%）为胰腺 NET，31 例（56.4%）为胃肠道 NET。在诊断时，28 例（51%）患者存在转移性疾病，50 例（91%）患者 68-Ga sstr PET/CT 阳性。总体而言，27 例（49%）患者 [F]FDG PET/CT 检查结果阳性。行 [F]FDG PET/CT 后，29 例（52.7%）患者的治疗管理发生了改变。阴性 [F]FDG PET/CT 患者的无进展生存期长于阳性 [F]FDG PET/CT 患者（中位 PFS 分别为未达到和 24 个月，p=0.04）。这种差异在胰腺组中尤为显著（p=0.008）。
尽管 G1 GEP-NET 的增殖活性较低，但约有一半表现为 [F]FDG PET/CT 阳性，这对患者的临床结局产生了相应的负面影响。这些数据支持在 G1 GEP-NET 的诊断性评估中对 [F]FDG PET/CT 的潜在使用持更“开放”的态度，在某些情况下，可用于检测那些疾病预后不良风险较高的患者。
