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SPECT- and PET-Based Patient-Tailored Treatment in Neuroendocrine Tumors

A Comprehensive Multidisciplinary Team Approach

Werner, R.A. MD*; Bluemel, Christina MD*; Lassmann, M. PhD*; Kudlich, T. MD; Higuchi, T. MD*; Lopci, Egesta MD; Allen-Auerbach, M. MD, MD§; Colletti, Patrick M. MD; Rubello, Domenico MD; Zatelli, M.C. MD**; Herrmann, Ken MD

doi: 10.1097/RLU.0000000000000729
Review Article
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The overexpression of somatostatin receptors on the tumor cell surface of neuroendocrine tumors (NETs) detected by multimodal functional imaging modalities such as SPECT and PET tracers constitutes a therapeutic option using targeting radiolabeled compounds. We will introduce the theranostic concept in general, explain in more detail its development in NETs, and discuss available SPECT and PET tracers regarding their potential for diagnostic imaging, visualization of target expression, and treatment tailoring. Moreover, we will discuss the currently available peptide receptor radionuclide therapy principles and compare them to previously published studies. Finally, we will discuss which new concepts will most likely influence the theranostic treatment approach in NETs in the future.

From the Departments of *Nuclear Medicine, and †Internal Medicine II, University Hospital of Würzburg, Würzburg, Germany; ‡Department of Nuclear Medicine, Humanitas Research Hospital, Rozzano, Milan, Italy; §Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA; ║Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, CA; ¶Department of Nuclear Medicine, Santa Maria della Misericordia Hospital, Rovigo; and **Department of Endocrinology, University of School of Ferrara, Ferrara, Italy.

Received for publication December 3, 2014; revision accepted December 10, 2014.

Conflicts of interest and sources of funding: none declared.

Reprints: Domenico Rubello, MD, Department of Imaging, Nuclear Medicine, PET/CT Centre, Via Tre Martiri 140, 45100 Rovigo, Italy. E-mail: domenico.rubello@libero.it.

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