Gastroenteropancreatic neuroendocrine tumors. Diagnosis and therapy in nuclear medicine

The over expression of somatostatin receptors (SSTR) in neuroendocrine tumors (NET) enables diagnosis and targeted therapy using radio-labelled somatostatin analogues. PET with Ga-68-DOTATATE or Ga-68-DOTATOC, both with a high affinity to the SSTR subtype 2, enables diagnosis of NET with a very high sensitivity and has a significant influence on the therapeutic management of patients with NET. In particular, therapy with Lu-177-DOTATATE, which offers a considerably lower nephrotoxicity as compared to Y-90-DOTATOC, has only few side effects and is usually well tolerated. Up to 46% of patients suffering from GEP-NET show a response to this therapy, which is able to mitigate tumour-related symptoms and significantly improve quality of life.