Somatostatin Receptor Imaging and Theranostics: Current Practice and Future Prospects

J Nucl Med. 2021 Oct;62(10):1323-1329. doi: 10.2967/jnumed.120.251512. Epub 2021 Jul 22.

Abstract

A new era of precision diagnostics and therapy for patients with neuroendocrine neoplasms began with the approval of somatostatin receptor (SSTR) radiopharmaceuticals for PET imaging followed by peptide receptor radionuclide therapy (PRRT). With the transition from SSTR-based γ-scintigraphy to PET, the higher sensitivity of the latter raised questions regarding the direct application of the planar scintigraphy-based Krenning score for PRRT eligibility. Also, to date, the role of SSTR PET in response assessment and predicting outcome remains under evaluation. In this comprehensive review article, we discuss the current role of SSTR PET in all aspects of neuroendocrine neoplasms, including its relation to conventional imaging, selection of patients for PRRT, and the current understanding of SSTR PET-based response assessment. We also provide a standardized reporting template for SSTR PET with a brief discussion.

Keywords: 68Ga-DOTANOC; 68Ga-DOTATATE; SSTR; neuroendocrine neoplasms; peptide receptor radionuclide therapy; somatostatin.

Publication types

  • Review

MeSH terms

  • Humans
  • Molecular Imaging / methods
  • Neuroendocrine Tumors* / diagnostic imaging
  • Neuroendocrine Tumors* / metabolism
  • Neuroendocrine Tumors* / radiotherapy
  • Neuroendocrine Tumors* / therapy
  • Positron-Emission Tomography* / methods
  • Precision Medicine
  • Radiopharmaceuticals / therapeutic use
  • Receptors, Somatostatin* / metabolism

Substances

  • Receptors, Somatostatin
  • Radiopharmaceuticals