E4750. Neuroendocrine Tumors: A Primer on Imaging and Therapies with Illustrative Cases
Authors
Bardia Nadim;
Brigham and Women's Hospital
Alexander Boyko;
Brigham and Women's Hospital
Michael Kavanaugh;
Brigham and Women's Hospital
Ramya Prabhu;
Brigham and Women's Hospital
Benjamin Auer;
Brigham and Women's Hospital
Hina Shah;
Brigham and Women's Hospital
Background
Neuroendocrine tumors (NETs) represent a heterogeneous group of neoplasms arising from neuroendocrine cells that are present throughout the body, most frequently within the gastrointestinal tract, pancreas, and lungs. Given the ability for some of these NETs to secrete biologically active hormones (i.e., “functioning” NETs), patients can present with a variety of clinical manifestations. As a result, NETs can pose unique challenges in diagnosis and treatment. Multiple imaging modalities are utilized to aid in diagnosis, including CT, MRI, and functional imaging with both 68Ga-DOTATATE and FDG PET/CT. Treatment of metastatic NETs include peptide receptor radionuclide therapy (PRRT) and transarterial chemoembolization (TACE) or radioembolization (TARE) for patients with hepatic-predominant metastases.
Educational Goals / Teaching Points
The goal of this exhibit is to provide an introductory overview of the imaging and therapies available in the diagnosis and treatment of NETs through a case-based approach.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We will present cases of different types and origins of NETs (i.e., gastrointestinal, pancreatic, lung) along with histological grade (i.e., well-differentiated or poorly differentiated) to highlight the importance of multimodal imaging in the accurate diagnosis and surveillance of these tumors. We will also present cases of patients that have undergone different therapies for metastatic NETs including PRRT (i.e., 177Lutetium-DOTATATE), TACE, and TARE.
Conclusion
NETs are a heterogeneous group of neoplasms that can affect a wide range of organ systems. Multiple imaging techniques such as CT, MRI, and PET/CT play pivotal roles in the accurate diagnosis of NETs. Moreover, the exploration of innovative therapeutic approaches including PRRT, TACE, and TARE underscores the evolving landscape of personalized and targeted treatments for these complex tumors.
