TY - JOUR
T1 - Frequency and characterization of gastro-entero-pancreatic neuroendocrine tumor patients with high-grade of uptake at somatostatin receptor scintigraphy
AU - Chougnet, Cecile N.
AU - Leboulleux, Sophie
AU - Caramella, Caroline
AU - Lumbroso, Jean
AU - Borget, Isabelle
AU - Déandreis, Désirée
AU - Duvillard, Pierre
AU - Elias, Dominique
AU - De Baere, Thierry
AU - Vélayoudom-Céphise, Fritz Line
AU - Guigay, Joël
AU - Ducreux, Michel
AU - Schlumberger, Martin
AU - Baudin, Eric
PY - 2013/4/1
Y1 - 2013/4/1
N2 - Recent studies suggest that the somatostatin receptor scintigraphy (SRS) grade of uptake is a predictor of response to peptide receptor radionuclide therapy (PRRT). To identify and characterize patients with well-differentiated (WD) neuroendocrine neoplasm (NEN) displaying a high-grade uptake at SRS. Patients with WD-NEN, whose SRS films were available for review, were retrospectively included. SRS was reviewed by three independent readers and classified into four subgroups based on a modified Krenning's scale (mKS): no uptake (group-0), homogeneous grade 1-2 uptake (group-1), homogeneous grade 3-4 (group-2), and heterogeneous grade 1-4 (group-3). A simplified scale (sS) of SRS was also used to look for characteristics of patients with high-grade uptake. One hundred and six WD-NEN patients were enrolled. Group-0, group-1, group-2, and group-3 were found in 17, 8, 33, and 42% of cases respectively. High-grade uptake at sS (75% of cases) was correlated with older age, functioning NEN, high chromogranin-A level, and grade 1 (G1) NEN based on mitotic count. Based on the mKS or sS scales, no difference on survival was found. Thirty-three to seventy-five percent of metastatic NEN patients can be considered candidates for PRRT based on homogeneous or heterogeneous high-grade uptake. Functioning G1 NEN patients could be the best candidates for PRRT. Randomized trials are expected to confirm this result.
AB - Recent studies suggest that the somatostatin receptor scintigraphy (SRS) grade of uptake is a predictor of response to peptide receptor radionuclide therapy (PRRT). To identify and characterize patients with well-differentiated (WD) neuroendocrine neoplasm (NEN) displaying a high-grade uptake at SRS. Patients with WD-NEN, whose SRS films were available for review, were retrospectively included. SRS was reviewed by three independent readers and classified into four subgroups based on a modified Krenning's scale (mKS): no uptake (group-0), homogeneous grade 1-2 uptake (group-1), homogeneous grade 3-4 (group-2), and heterogeneous grade 1-4 (group-3). A simplified scale (sS) of SRS was also used to look for characteristics of patients with high-grade uptake. One hundred and six WD-NEN patients were enrolled. Group-0, group-1, group-2, and group-3 were found in 17, 8, 33, and 42% of cases respectively. High-grade uptake at sS (75% of cases) was correlated with older age, functioning NEN, high chromogranin-A level, and grade 1 (G1) NEN based on mitotic count. Based on the mKS or sS scales, no difference on survival was found. Thirty-three to seventy-five percent of metastatic NEN patients can be considered candidates for PRRT based on homogeneous or heterogeneous high-grade uptake. Functioning G1 NEN patients could be the best candidates for PRRT. Randomized trials are expected to confirm this result.
KW - Carcinoid
KW - Computed tomography
KW - Predictor
KW - Prognosis
KW - Somatostatin receptor scintigraphy
KW - Well-differentiated neuroendocrine tumor
UR - http://www.scopus.com/inward/record.url?scp=84876769396&partnerID=8YFLogxK
U2 - 10.1530/ERC-12-0169
DO - 10.1530/ERC-12-0169
M3 - Article
C2 - 23404855
AN - SCOPUS:84876769396
SN - 1351-0088
VL - 20
SP - 229
EP - 239
JO - Endocrine-Related Cancer
JF - Endocrine-Related Cancer
IS - 2
ER -