Functional imaging in the follow-up of enteropancreatic neuroendocrine tumors: Clinical usefulness and indications

E Merola, ME Pave, F Panzuto, G Capurso, N Cicchese, A Rinke, TM Gress, E Iannicelli, D Prosperi, P Pizzichini, V Prasad, P Kump, R Lipp, S Partelli, M Falconi, B Wiedenmann, Gianfranco Delle Fave

Research output: Contribution to journalArticle

Abstract

Context: Functional imaging tests (FITs) detecting somatostatin receptor expression [i.e., somatostatin receptor scintigraphy, 68Ga-DOTA positron emission tomography/computed tomography (CT)] have a pivotal role in the diagnosis of neuroendocrine tumors (NETs), although their indication during follow-up still needs to be clarified. Objective: Investigate the role of FITs after diagnosis of metastatic enteropancreatic NETs, identifying patients who might benefit from these exams. Design: Multicenter retrospective analysis of metastatic enteropancreatic NETs. Setting: Analysis of imaging tests performed between January 1995 and December 2015 in Rome, Berlin, Milan, Marburg, or Graz. Subjects: One hundred forty-three patients with metastatic pancreatic NETs and small intestine NETs, at least 2-year follow-up, and positive FITs. Interventions: Patients had received CT every 6 months (unless clinical conditions and tumor behavior required shorter intervals) and FIT every 12 months. Main Outcome Measures: Clinical usefulness of FITs, defined as changes in patient management (indication to biopsy, medical therapy, surgery, or further imaging tests) due only to FITs. Results: FITs affected management in 73.4% of patients, mostly when G2 vs G1 [odds ratio (OR), 2.40; 95% confidence interval (CI), 1.09 to 5.27;P= 0.03] . Changes were observed in a 12-month time frame especiallywith pancreatic NETs vs small intestine NETs (OR, 2.89; 95%CI, 1.09-7.67; P = 0.03) or metastases since diagnosis vs developed during follow-up (OR, 4.00; 95% CI, 1.43 to 11.17; P , 0.01). Conclusions: FITs used in addition to CT in the follow-up of stage IV enteropancreatic NETs improve patient management (especially for G2 tumors). Follow-up program should be tailored according to tumor featur es. (J Clin Endocrinol Metab 102: 1486-1494, 2017). © 2017 Endocrine Society.
Original languageEnglish
Pages (from-to)1486-1494
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume102
Issue number5
DOIs
Publication statusPublished - 2017

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Neuroendocrine Tumors
Tumors
Imaging techniques
Somatostatin Receptors
Odds Ratio
Confidence Intervals
Tomography
Small Intestine
Neoplasms
Berlin
Radionuclide Imaging
Positron emission tomography
Biopsy
Outcome Assessment (Health Care)
Neoplasm Metastasis
Surgery

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Functional imaging in the follow-up of enteropancreatic neuroendocrine tumors: Clinical usefulness and indications. / Merola, E; Pave, ME; Panzuto, F; Capurso, G; Cicchese, N; Rinke, A; Gress, TM; Iannicelli, E; Prosperi, D; Pizzichini, P; Prasad, V; Kump, P; Lipp, R; Partelli, S; Falconi, M; Wiedenmann, B; Delle Fave, Gianfranco.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 102, No. 5, 2017, p. 1486-1494.

Research output: Contribution to journalArticle

Merola, E, Pave, ME, Panzuto, F, Capurso, G, Cicchese, N, Rinke, A, Gress, TM, Iannicelli, E, Prosperi, D, Pizzichini, P, Prasad, V, Kump, P, Lipp, R, Partelli, S, Falconi, M, Wiedenmann, B & Delle Fave, G 2017, 'Functional imaging in the follow-up of enteropancreatic neuroendocrine tumors: Clinical usefulness and indications', Journal of Clinical Endocrinology and Metabolism, vol. 102, no. 5, pp. 1486-1494. https://doi.org/10.1210/jc.2016-3732
Merola, E ; Pave, ME ; Panzuto, F ; Capurso, G ; Cicchese, N ; Rinke, A ; Gress, TM ; Iannicelli, E ; Prosperi, D ; Pizzichini, P ; Prasad, V ; Kump, P ; Lipp, R ; Partelli, S ; Falconi, M ; Wiedenmann, B ; Delle Fave, Gianfranco. / Functional imaging in the follow-up of enteropancreatic neuroendocrine tumors: Clinical usefulness and indications. In: Journal of Clinical Endocrinology and Metabolism. 2017 ; Vol. 102, No. 5. pp. 1486-1494.
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abstract = "Context: Functional imaging tests (FITs) detecting somatostatin receptor expression [i.e., somatostatin receptor scintigraphy, 68Ga-DOTA positron emission tomography/computed tomography (CT)] have a pivotal role in the diagnosis of neuroendocrine tumors (NETs), although their indication during follow-up still needs to be clarified. Objective: Investigate the role of FITs after diagnosis of metastatic enteropancreatic NETs, identifying patients who might benefit from these exams. Design: Multicenter retrospective analysis of metastatic enteropancreatic NETs. Setting: Analysis of imaging tests performed between January 1995 and December 2015 in Rome, Berlin, Milan, Marburg, or Graz. Subjects: One hundred forty-three patients with metastatic pancreatic NETs and small intestine NETs, at least 2-year follow-up, and positive FITs. Interventions: Patients had received CT every 6 months (unless clinical conditions and tumor behavior required shorter intervals) and FIT every 12 months. Main Outcome Measures: Clinical usefulness of FITs, defined as changes in patient management (indication to biopsy, medical therapy, surgery, or further imaging tests) due only to FITs. Results: FITs affected management in 73.4{\%} of patients, mostly when G2 vs G1 [odds ratio (OR), 2.40; 95{\%} confidence interval (CI), 1.09 to 5.27;P= 0.03] . Changes were observed in a 12-month time frame especiallywith pancreatic NETs vs small intestine NETs (OR, 2.89; 95{\%}CI, 1.09-7.67; P = 0.03) or metastases since diagnosis vs developed during follow-up (OR, 4.00; 95{\%} CI, 1.43 to 11.17; P , 0.01). Conclusions: FITs used in addition to CT in the follow-up of stage IV enteropancreatic NETs improve patient management (especially for G2 tumors). Follow-up program should be tailored according to tumor featur es. (J Clin Endocrinol Metab 102: 1486-1494, 2017). {\circledC} 2017 Endocrine Society.",
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T1 - Functional imaging in the follow-up of enteropancreatic neuroendocrine tumors: Clinical usefulness and indications

AU - Merola, E

AU - Pave, ME

AU - Panzuto, F

AU - Capurso, G

AU - Cicchese, N

AU - Rinke, A

AU - Gress, TM

AU - Iannicelli, E

AU - Prosperi, D

AU - Pizzichini, P

AU - Prasad, V

AU - Kump, P

AU - Lipp, R

AU - Partelli, S

AU - Falconi, M

AU - Wiedenmann, B

AU - Delle Fave, Gianfranco

PY - 2017

Y1 - 2017

N2 - Context: Functional imaging tests (FITs) detecting somatostatin receptor expression [i.e., somatostatin receptor scintigraphy, 68Ga-DOTA positron emission tomography/computed tomography (CT)] have a pivotal role in the diagnosis of neuroendocrine tumors (NETs), although their indication during follow-up still needs to be clarified. Objective: Investigate the role of FITs after diagnosis of metastatic enteropancreatic NETs, identifying patients who might benefit from these exams. Design: Multicenter retrospective analysis of metastatic enteropancreatic NETs. Setting: Analysis of imaging tests performed between January 1995 and December 2015 in Rome, Berlin, Milan, Marburg, or Graz. Subjects: One hundred forty-three patients with metastatic pancreatic NETs and small intestine NETs, at least 2-year follow-up, and positive FITs. Interventions: Patients had received CT every 6 months (unless clinical conditions and tumor behavior required shorter intervals) and FIT every 12 months. Main Outcome Measures: Clinical usefulness of FITs, defined as changes in patient management (indication to biopsy, medical therapy, surgery, or further imaging tests) due only to FITs. Results: FITs affected management in 73.4% of patients, mostly when G2 vs G1 [odds ratio (OR), 2.40; 95% confidence interval (CI), 1.09 to 5.27;P= 0.03] . Changes were observed in a 12-month time frame especiallywith pancreatic NETs vs small intestine NETs (OR, 2.89; 95%CI, 1.09-7.67; P = 0.03) or metastases since diagnosis vs developed during follow-up (OR, 4.00; 95% CI, 1.43 to 11.17; P , 0.01). Conclusions: FITs used in addition to CT in the follow-up of stage IV enteropancreatic NETs improve patient management (especially for G2 tumors). Follow-up program should be tailored according to tumor featur es. (J Clin Endocrinol Metab 102: 1486-1494, 2017). © 2017 Endocrine Society.

AB - Context: Functional imaging tests (FITs) detecting somatostatin receptor expression [i.e., somatostatin receptor scintigraphy, 68Ga-DOTA positron emission tomography/computed tomography (CT)] have a pivotal role in the diagnosis of neuroendocrine tumors (NETs), although their indication during follow-up still needs to be clarified. Objective: Investigate the role of FITs after diagnosis of metastatic enteropancreatic NETs, identifying patients who might benefit from these exams. Design: Multicenter retrospective analysis of metastatic enteropancreatic NETs. Setting: Analysis of imaging tests performed between January 1995 and December 2015 in Rome, Berlin, Milan, Marburg, or Graz. Subjects: One hundred forty-three patients with metastatic pancreatic NETs and small intestine NETs, at least 2-year follow-up, and positive FITs. Interventions: Patients had received CT every 6 months (unless clinical conditions and tumor behavior required shorter intervals) and FIT every 12 months. Main Outcome Measures: Clinical usefulness of FITs, defined as changes in patient management (indication to biopsy, medical therapy, surgery, or further imaging tests) due only to FITs. Results: FITs affected management in 73.4% of patients, mostly when G2 vs G1 [odds ratio (OR), 2.40; 95% confidence interval (CI), 1.09 to 5.27;P= 0.03] . Changes were observed in a 12-month time frame especiallywith pancreatic NETs vs small intestine NETs (OR, 2.89; 95%CI, 1.09-7.67; P = 0.03) or metastases since diagnosis vs developed during follow-up (OR, 4.00; 95% CI, 1.43 to 11.17; P , 0.01). Conclusions: FITs used in addition to CT in the follow-up of stage IV enteropancreatic NETs improve patient management (especially for G2 tumors). Follow-up program should be tailored according to tumor featur es. (J Clin Endocrinol Metab 102: 1486-1494, 2017). © 2017 Endocrine Society.

U2 - 10.1210/jc.2016-3732

DO - 10.1210/jc.2016-3732

M3 - Article

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JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

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