Endocrine Abstracts

Background: In southeast Scotland patients who have undergone resection of small intestinal neuroendocrine tumours (SI NETs) with curative intent are followed up by the NET team for recurrence. ENETs guidelines are that this should involve cross sectional imaging and hormonal assessment. During follow up we identified a number of patients with residual disease post surgery, rather than developing metachronous metastases. In 2019 we changed our policy to arrange post-operative (post-op) functional imaging in patients who had not had functional imaging in the pre-operative setting. During this time period we have moved from post-op tektrotyd scans to post-op Dotatoc PET imaging. We now review our first 5 years of post-op functional imaging.

Methods: We identified patients (n = 64) who had undergone a small intestinal resection since August 2019-2024 from MDT lists. This was then cross checked against a pathology database of patients with a NET identified in the small intestine, and one additional patient was identified. We looked at reports of imaging that had been performed and whether residual disease was found.

Results: We identified 64 patients who had undergone a resection from 2019-2024. In 17 patients surgery was with palliative intent, whereas 47 patients had undergone potentially curative surgery of which in 3 this included hepatic resection. In 12 patients no functional imaging was performed at any time due to comorbidity or patient request. Seven patients had undergone pre-operative functional imaging and no post-op functional imaging was arranged in these patients. Twelve patients underwent a post-op tektrotyd scan in which 4 had previously unknown residual disease found on scan (33%). Sixteen patients underwent a post-op Dotatoc PET scan in which unanticipated residual disease was identified in 9 (56%). We will present further analysis of these patients.

Conclusion: In patients where it is considered appropriate to perform follow up after resection of a SI NET, post-operative functional imaging should be performed.