Endocrine Abstracts

The imaging of neuroendocrine tumours (NET) is multimodal and is often initiated by cross sectional imaging, usually CT. Imaging with CT demonstrates metastatic disease more frequently than locating the primary lesion. Subsequent imaging relies on somatostatin receptor (SSR) scintigraphy, usually with the use of indium octreotide. SSR scintigraphy is commonly supplemented with SPECT CT to help localise the sites of metastatic deposits more accurately by delineating the associated anatomical structures and often helps to localise the site of primary disease. This approach not only improves diagnostic confidence but also functions to further inform management options. More recently, PET-CT using gallium labelled tracers have proved to be more sensitive in imaging NET; improving on spatial resolution, tumour contrast and speed of acquisition. It has also been used in the direction of neuroendocrine therapy, in particular peptide receptor radionuclide therapy and has been also considered as a replacement for scintigraphy entirely in some centres. We outline the value of imaging including ultrasound, functional and hybrid imaging in the diagnosis and follow up of NET. We will also discuss the value that SPECT CT imaging has over cross sectional and conventional planar SSR imaging. In addition, the added benefit and appropriate use of PET CT and new tracers is also highlighted.