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SPECIAL ARTICLE THERAGNOSTICS APPLICATIONS AND CHALLENGES
The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2021 December;65(4):342-52
DOI: 10.23736/S1824-4785.21.03426-9
Copyright © 2021 EDIZIONI MINERVA MEDICA
language: English
Theragnostic in neuroendocrine tumors
Irene MARINI 1, Maddalena SANSOVINI 1, Alberto BONGIOVANNI 2, Silvia NICOLINI 1, Ilaria GRASSI 1, Nicoletta RANALLO 2, Manuela MONTI 3, Valentina DI IORIO 4, Luca GERMANÒ 1, Paola CAROLI 1, Anna SARNELLI 5, Giovanni PAGANELLI 1, Stefano SEVERI 1 ✉
1 Unit of Nuclear Medicine, IRCCS Istituto Romagnolo per lo Studio dei Tumori - IRST Dino Amadori, Meldola, Forlì-Cesena, Italy; 2 Osteoncology and Rare Tumors Center - CDO-TR, IRCCS Istituto Romagnolo per lo Studio dei Tumori - IRST Dino Amadori, Meldola, Forlì-Cesena, Italy; 3 Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori - IRST Dino Amadori, Meldola, Forlì-Cesena, Italy; 4 Unit of Oncological Pharmacy, IRCCS Istituto Romagnolo per lo Studio dei Tumori - IRST Dino Amadori, Meldola, Forlì-Cesena, Italy; 5 Unit of Medical Physics, IRCCS Istituto Romagnolo per lo Studio dei Tumori - IRST Dino Amadori, Meldola, Forlì-Cesena, Italy
In the last few decades, the incidence and prevalence of neuroendocrine tumors has been increasing. The theragnostic approach, that allows the diagnosis and treatment of different neoplasms with the same ligand, is a typical nuclear medicine tool. Applied for years, is also pivotal in neuroendocrine tumors (NETs) where it has improved the diagnostic accuracy and the therapeutic efficacy with impact on patient’s survival. Theragnostic also allows the identification of important prognostic factors such as tumor location and burden, presence of liver metastases and intensity of somatostatin receptors (SSTR) expression to consider in new and possibly combined studies to ameliorate patient’s outcome. Moreover, the possibility to evaluate receptor expression even in non-NET malignancies has de facto widened the possible indications for PRRT. We believe that this innovative therapeutic approach will be implemented in next years by radiomics and biological tumors characterization to better address PRRT applications.
KEY WORDS: Neuroendocrine tumors; Lutetium; Receptors, somatostatin