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J Zhejiang Univ (Med Sci)  2021, Vol. 50 Issue (1): 131-137    DOI: 10.3724/zdxbyxb-2021-0031
    
Application of molecular probes in nuclear imaging of neuroendocrine tumors
YAN Jing(),ZHANG Tingting,ZHAO Kui()
Department of PET,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China
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Abstract  

Neuroendocrine tumors are a type of heterogeneous tumors originating from neuroendocrine cells derived from the neural crest,which can secrete a variety of amines and peptide hormones.Based on different molecular biomarkers,histologic types and differentiation degrees,individualized nuclear imaging can provide information for the early diagnosis,clinical staging,treatment guidance,and detection of the recurrence and metastasis of neuroendocrine tumor. In this paper,we review the development and application of nuclear medicine molecular imaging probes such as glucose analogs,somatostatin analogues,amine precursors,hormone analogs and enzyme inhibitors in the diagnosis and treatment of neuroendocrine tumors.



Key wordsNeuroendocrine tumors      Diagnosis      Molecular probe      Nuclear medicine imaging      Review     
Received: 03 August 2020      Published: 16 May 2021
CLC:  R445.5  
  R445.5  
  A  
Corresponding Authors: ZHAO Kui     E-mail: yanjing9986@163.com;zyzhaokui@163.com
Cite this article:

YAN Jing,ZHANG Tingting,ZHAO Kui. Application of molecular probes in nuclear imaging of neuroendocrine tumors. J Zhejiang Univ (Med Sci), 2021, 50(1): 131-137.

URL:

http://www.zjujournals.com/med/10.3724/zdxbyxb-2021-0031     OR     http://www.zjujournals.com/med/Y2021/V50/I1/131


核医学分子影像探针应用于神经内分泌肿瘤的研究进展

神经内分泌肿瘤起源于神经嵴来源的神经内分泌细胞,可分泌多种胺和多肽激素进入全身循环。核医学分子影像探针在神经内分泌肿瘤的早期诊断、临床分期、治疗方案选择、复发和转移病灶的探查中具有重要意义,临床可根据神经内分泌肿瘤细胞增殖及分化程度、细胞表面的分子表达、肿瘤部位选择分子影像探针进行个体化显像。本文就葡萄糖类似物显像剂、生长抑素类似物显像剂、胺前体类显像剂、激素类似物显像剂和酶抑制剂类显像剂等核医学分子影像探针在神经内分泌肿瘤诊断和治疗中的发展及应用进行综述。


关键词: 神经内分泌肿瘤,  诊断,  分子探针,  核医学显像,  综述 

探针类型

显像剂

检查方法

适用类型

优点

缺点

葡萄糖类似物

18F-FDG

PET/CT、PET/MR

中高级别NET

广谱肿瘤显像剂,能用于高级别(G3)NET

对低级别(G1~G2)NET敏感度低

生长抑素类似物

123I/ 111In-奥曲肽(喷曲肽)

γ相机、SPECT、SPECT/CT

SSTR表达NET,包括胃肠胰NET、肺类癌、嗜铬细胞瘤及副交感神经节瘤;PRRT治疗前影像学评估

最早进入临床的生长抑素受体类显像剂

受显像设备影响,分辨率较低、肝脏生理性摄取高

68Ga-DOTA-多肽

PET/CT、PET/MR

可与SSTR高表达的NET特异性结合,PRRT治疗前影像评估

合成成本较高,产量较低

18F-AlF-NOTA-奥曲肽

PET/CT、PET/MR

肝脏本底较低, 18F半衰期较长,利于临床推广

相关文献报道较少

胺前体类

11C-5-羟色胺

PET/CT、PET/MR

所有类型的NET,包括类癌及胰腺内分泌瘤

适用于SSTR表达不确定NET

11C半衰期短,生产复杂,产量较低,应用受限

18F-FDOPA

PET/CT、PET/MR

分化好、血清素A升高的NET,尤其是低SSTR表达或表达不确定的 NET

适用于SSTR表达不确定的或中肠型NET

胰腺本底较高

激素类似物

131I/ 123I/间碘卞胍

SPECT、SPECT/CT

嗜铬细胞瘤及神经节瘤

肾上腺髓质显像剂,核素治疗评估

所标记放射性核素生物半衰期过短或 过长

11C-羟基麻黄碱

PET/CT、PET/MR

嗜铬细胞瘤

在嗜铬细胞瘤中的敏感度和特异性高

对染色体遗传相关的NET不敏感

酶抑制剂

11C-依托咪酯

PET/CT、PET/MR

肾上腺皮质来源肿瘤

肾上腺皮质来源的NET

11C半衰期短,不利于储存及运输

123I-碘甲咪唑

SPECT、SPECT/CT

肾上腺皮质癌

123I半衰期长(13.2?h)

Table 1 Application of molecular probes in nuclear imaging of neuroendocrine tumors (NET)
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