Use and perceived utility of [18F]FDG PET/CT in neuroendocrine neoplasms: A consensus report from the European Neuroendocrine Tumor Society (ENETS) Advisory Board Meeting 2022

Ambrosini V, Caplin M, Castaño JP, Christ E, Denecke T, Deroose CM, Dromain C, Falconi M, Grozinsky-Glasberg S, Hicks RJ, Hofland J, Kjaer A, Knigge UP, Kos-Kudla B, Koumarianou A, Krishna B, Lamarca A, Pavel ME, Reed NS, Scarpa A, Srirajaskanthan R, Sundin A, Toumpanakis C, Prasad V (2023)

Publication Type: Journal article

Publication year: 2023

Journal

DOI: 10.1111/jne.13359

Abstract

Somatostatin receptor (SST) PET/CT is the gold standard for well-differentiated neuroendocrine tumours (NET) imaging. Higher grades of neuroendocrine neoplasms (NEN) show preferential [18F]FDG (FDG) uptake, and even low-grade NET may de-differentiate over time. FDG PET/CT's prognostic role is widely accepted; however, its impact on clinical decision-making remains controversial and its use varies widely. A questionnaire-based survey on FDG PET/CT use and perceived decision-making utility in NEN was submitted to the ENETS Advisory Board Meeting attendees (November 2022, response rate = 70%). In 3/15 statements, agreement was higher than 75%: (i) FDG was considered useful in NET, irrespective of grade, in case of mis-matched lesions (detectable on diagnostic CT but negative/faintly positive on SST PET/CT), especially if PRRT is contemplated (80%); (ii) in NET G3 if curative surgery is considered (82%); and (iii) in NEC prior to surgery with curative intent (98%). FDG use in NET G3, even in the presence of matched lesions, as a baseline for response assessment was favoured by 74%. Four statements obtained more than 60% consensus: (i) FDG use in NET G3 if locoregional therapy is considered (65%); (ii) in neuroendocrine carcinoma before initiating active therapy as a baseline for response assessment (61%); (iii) biopsy to re-assess tumour grade prior to a change in therapeutic management (68%) upon detection of FDG-positivity on the background of a prior G1-2 NET; (iv) 67% were in favour to reconsider PRRT to treat residual SST-positive lesions after achieving complete remission on FDG of the SST-negative disease component. Multidisciplinary opinion broadly supports the use of FDG PET/CT for characterisation of disease biology and to guide treatment selection across a range of indications, despite the lack of full consensus in many situations. This may reflect existing clinical access due to lack of reimbursement or experience with this investigation, which should be addressed by further research.

Authors with CRIS profile

Involved external institutions

Beatson West of Scotland Cancer Centre (BWSCC) United Kingdom (GB) University of Bologna / Università di Bologna Italy (IT) Royal Free Hospital United Kingdom (GB) Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) Spain (ES) Universitätsspital Basel Switzerland (CH) Erasmus University Medical Center (MC) Netherlands (NL) Rigshospitalet Denmark (DK) Medical University of Silesia in Katowice / Śląski Uniwersytet Medyczny w Katowicach (SUM) Poland (PL) Attikon Hospital / Πανεπιστημιακού Γενικού Νοσοκομείου "Αττικόν" Greece (GR) Lilavati Hospital & Research Centre India (IN) Hospital Universitario Fundación Jiménez Díaz Spain (ES) Universitätsklinikum Leipzig Germany (DE) Katholieke Universiteit Leuven (KUL) / Catholic University of Leuven Belgium (BE) University of Verona / Università degli Studi di Verona Italy (IT) Lausanne University Hospital / Centre hospitalier universitaire vaudois (CHUV) Switzerland (CH) King's College Hospital (KCH) United Kingdom (GB) Ospedale San Raffaele (früher: Centro San Raffaele del Monte Tabor Foundation) Italy (IT) The University of Melbourne Australia (AU) Uppsala University Sweden (SE) Washington University United States (USA) (US)

How to cite

APA:

Ambrosini, V., Caplin, M., Castaño, J.P., Christ, E., Denecke, T., Deroose, C.M.,... Prasad, V. (2023). Use and perceived utility of [18F]FDG PET/CT in neuroendocrine neoplasms: A consensus report from the European Neuroendocrine Tumor Society (ENETS) Advisory Board Meeting 2022. Journal of Neuroendocrinology. https://doi.org/10.1111/jne.13359

MLA:

Ambrosini, Valentina, et al. "Use and perceived utility of [18F]FDG PET/CT in neuroendocrine neoplasms: A consensus report from the European Neuroendocrine Tumor Society (ENETS) Advisory Board Meeting 2022." Journal of Neuroendocrinology (2023).

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