Molecular Imaging of Gastroenteropancreatic Neuroendocrine Tumors

An overview of the current status and future directions in molecular imaging of gastroenteropancreatic neuroendocrine tumors.

Course ID: Q00524 Category:
Modalities: , , , , ,

2.0

Satisfaction Guarantee

$24.00

View cart

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Nuclear Medicine Technology: 1.00
Procedures: 1.00
Endocrine and Oncology Procedures: 1.00

Outline

  1. Introduction
  2. Overview of GEP NETS
    1. Presentation
    2. Tumor Grading and Disease Staging
    3. Role of Imaging
  3. Conventional Morphologic Procedures
    1. Primary Tumor Detection
    2. Tumor Extent and Metastatic Spread
  4. Radionuclide Imaging
    1. Radiolabeled Somatostatin Analogs
    2. Radiolabeled MIBG
    3. 18F-Fluorodihydroxyphenylalanine (18F-FDOPA
    4. 18F-FDG
  5. Toward Personalized Medicine
    1. Proposed Imaging Algorithm
    2. Therapeutic Decision Making
    3. Theranostics: The Image-and-Treat Attitude
  6. Conclusion

Objectives

Upon completion of this course, students will:

  1. know the type of neoplasms that GEP NETs are
  2. be familiar with the various types of gastric NETs
  3. be familiar with the presentation of duodenal NETs
  4. understand the basic facts associated with pancreatic NETs
  5. be familiar with the presentation of small-intestinal NETs
  6. know the symptoms of colonic NETs
  7. be familiar with the 2010 WHO GEP NET classification criteria
  8. know the GEP NET staging criteria
  9. know the value of functional imaging techniques to the management of patients with GEP NETs
  10. be familiar with the various conventional morphologic procedures for NETs
  11. recognize the primary characteristics and advantages of the currently available endoscopic and anatomic-imaging techniques for GEP NET investigation
  12. understand the strengths of both contrast-enhanced CT and MR for evaluation of GEP NET extent and metastatic spread
  13. be familiar with the processes that have been exploited for radiotracer development for radionuclide imaging of NETs
  14. know which SSTRs subtype is most frequently expressed by GEP NETs
  15. be familiar with the usage and advantages of 111In pentetreotide
  16. know the radiotracers that are collectively referred to as 68GA-DOTA-peptides
  17. know the SSTR subtypes for which 68GA-DOTA-peptides have affinity
  18. understand the advantages of 68GA-DOTA-peptide imaging over 111In-pentetreotide imaging
  19. understand how the sensitivity of 68GA-DOTATATE can lead to a change in therapy decisions, as found in the prospective study by Sadowski et al cited in the article
  20. know the condition for which 68GA-peptide PET/CT is recommended in all patients
  21. know the reasons for 68GA-peptide PET/CT to assess for NET recurrence
  22. be familiar with the benefits of using 68GA-DOTA-peptide PET imaging versus 111In-pentetreotide SPECT imaging
  23. be familiar with the conditions that can be detected with 68GA-peptide PET imaging, even though insulinoma detection through SSTR imaging has classically been associated with low sensitivity
  24. know the relationship between 68GA-DOTA-peptide PET/CT and PRRT
  25. be familiar with the pitfalls of SSTR PET imaging
  26. understand the advantages of the proposed radiolabeled antagonists over the current agonist imaging agents
  27. be familiar with the facts about radiolabeled MIBG imaging
  28. know the cases where 18F-FDOPA has excellent imaging sensitivity
  29. know where 18F-FDOPA PET/CT is superior to both CT and 111In-pentetreotide SSTR scintigraphy
  30. know a definite advantage of 68GA-DOTA-peptide PET/CT over 18F-FDOPA PET/CT
  31. know what is crucial for treatment planning, since surgical resection is associated with better symptom-free survival, overall survival, and quality of life
  32. know how 18F-FDOPA PET/CT of adult insulinoma detection might be improved
  33. know the GEP NET grades for which 18F-FDG is the preferred radiotracer
  34. understand the importance of increased 18F-FDG uptake to NET diagnosis
  35. be familiar with the proposed diagnostic imaging algorithm for patients with GEP NETs
  36. know the factors that play into the choice of morphologic and functional imaging techniques in the proposed diagnostic imaging algorithm for patients with GEP NETs
  37. be familiar with the available therapeutic options for unresectable advanced or metastatic GEP NET disease from well-differentiated tumors
  38. know the factors that affect management of GEP NET patients
  39. understand the so called “flip-flop phenomenon” relationship between the uptake of radiolabeled SSAs (or 18F-FDOPA) and that of 18F-FDG in low and high grade GEP NETs
  40. understand the term “theranostics” and what aspects of personalized medicine are integrated in theranostic patient management