Ces radiol. 2011, 65(3):196-201

Contrast-enhanced 18F-FDG PET/CT in patients with metastatic malignant neuroendocrine tumorsOriginal article

Pavel Koranda1, Miroslav Mysliveček1, Hana Švébišová2, Zdeněk Fryšák3, Radim Formánek1, Eva Buriánková1
1 Klinika nukleární medicíny FN a LF UP, Olomouc
2 Onkologická klinika FN a LF UP, Olomouc
3 III. interní klinika FN a LF UP, Olomouc

Aim: The majority of neuroendocrine tumors (NETs) exhibits an indolent growth pattern (well-differentiated tumors), but a substantial number may metastasize. The minority of NETs is aggressive and can have a highly malignant course. The aim of the study was to evaluate the reliability of contrast-enhanced 18F-FDG PET/CT in the staging of malignant NETs.

Method: A total of 41 patients with verified or suspected NETs underwent contrast-enhanced 18F-FDG PET/CT. NETs were histologically verified in 29 patients (15 carcinoids, 8 neuroendocrine carcinomas, 2 medullary carcinomas, 2 Merkel cell carcinomas, 1 pheochromocytoma, 1 inzulinoma). 111In-pentetreotide or 123I-MIBG scintigraphies were performed in patients with absent or spurious accumulation of 18F-FDG.

Results: 18F-FDG PET/CT did not reveal 18F-FDG uptake in 6 patients with histologically confirmed NETs (5/15 carcinoids, 1/8 neuroendocrine carcinomas) only. The NETs were detected using 111In-pentetreotide or 123I-MIBG scintigraphy in all 18F-FDG negative patients. On the contrary, 18F-FDG PET/CT was more accurate than 111In-pentetreotide or 123I-MIBG scintigraphy in patients with high-grade neuroendocrine carcinomas and medullar thyroid carcinomas.

Conclusion: Contrast enhanced 18F-FDG PET/CT identified malignant tissue in the majority of patients with malignant NETs, 18F-FDG PET/CT was an efficient diagnostic tool in patients with intermediate- and high-grade NETs. 18F-FDG PET/CT and 111In-pentetreotide scintigraphy are complementary examinations - functional imaging with both radiopharmaceuticals has a potential for a more comprehensive assessment of these tumors.

Keywords: 18F-FDG, 111In-pentetrotide, positron-emission tomography, X-ray computed tomography, neuroendocrine tumors

Accepted: December 15, 2010; Published: September 1, 2011  Show citation

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Koranda P, Mysliveček M, Švébišová H, Fryšák Z, Formánek R, Buriánková E. Contrast-enhanced 18F-FDG PET/CT in patients with metastatic malignant neuroendocrine tumors. Ces radiol. 2011;65(3):196-201.
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