Role of [18F]FDG PET/CT in the management of G1 gastro-entero-pancreatic neuroendocrine tumors

• Published in: Endocrine 2022-05, Vol.76 (2), p.484-490
• Main Authors: Magi, Ludovica, Prosperi, Daniela, Lamberti, Giuseppe, Marasco, Matteo, Ambrosini, Valentina, Rinzivillo, Maria, Campana, Davide, Gentiloni, Guido, Annibale, Bruno, Signore, Alberto, Panzuto, Francesco
• Format: Article
• Language: English
• Subjects: Diabetes; Disease management; Endocrinology; Fluorodeoxyglucose F18; Humanities and Social Sciences; Humans; Internal Medicine; Intestinal Neoplasms; Medicine; Medicine & Public Health; Metastases; multidisciplinary; Neuroendocrine tumors; Neuroendocrine Tumors - pathology; Organometallic Compounds - therapeutic use; Original; Original Article; Pancreas; Pancreatic Neoplasms - pathology; Patients; Positron emission tomography; Positron Emission Tomography Computed Tomography; Retrospective Studies; Science; Stomach Neoplasms
• ISSN: 1559-0100; 1355-008X; 1559-0100
• DOI: 10.1007/s12020-022-03000-3

Purpose Since the role of [ 18 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 [ 18 F]FDG PET/CT in grade 1 (G1) GEP-NETs. Methods This is a retrospective study including patients with G1 GEP-NETs who underwent [ 18 F]FDG PET/CT. Results 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 [ 18 F]FDG PET/CT. Following [ 18 F]FDG PET/CT, therapeutic management was modified in 29 (52.7%) patients. Progression-free survival was longer in patients with negative [ 18 F]FDG PET/CT compared with positive [ 18 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). Conclusions Despite having low proliferative activity, approximately half of GEP-NETs G1 showed positive [ 18 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 [ 18 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.