Nets: From diagnosis to therapy – a theragnostic approach: Part i

Diagnostics and therapy in neuroendocrine tumors (NETs) has been heavily influenced by nuclear medicine progresses, both from a diagnostic and therapeutic perspective. The introduction of somatostatin-based peptides, labeled to radionuclides (constituting radiopharmaceuticals), such as the current golden standard 68Ga-DOTA-SSAs (SomatoStatin Analogues), has revolutionized the approach to these neoplasms. Peptides-based drugs in NENs’ management have been introduced with OctreoScan® (111In-DTPA-octreotide) in combination with scintigraphy, but today techniques have deeply evolved, allowing better performance together with higher accuracy and sensitivity, in addition to image quality improvements (also in terms of details and anatomical data), especially thanks to the implementation of hybrid techniques, such as SPECT/CT and PET/CT. 68Ga-based radiotracers are not the only diagnostic option in NENs, because of the existence of several tumors (such as insulinomas or malignant neoplasms) that do not express SSAs’ target molecules, thus the utilization of other radiocompunds is needed, such as 18F-FDG.