神经内分泌肿瘤（NEN）起源于神经内分泌系统的分泌细胞，大多数起源于胃肠道和胰腺。鉴于这些肿瘤的生物学行为和形态分化的异质性，先进的成像技术对于支持疑似诊断、准确分期和监测治疗至关重要。由于大多数分化良好的 NEN 表现出细胞表面生长抑素受体 (SSR) 的过度表达，因此 SSR 导向的 PET/CT 被认为是该特定实体成像的参考标准。 SSR-PET/CT 应成为每个 NEN G1 或 G2 的首选影像学方法，并考虑在潜在治愈性和非治愈性手术后进行重新分期。 SSR 表达的程度对于确定患者是否有资格接受肽受体放射性核素治疗 (PRRT) 也至关重要。 PRRT 利用 [177Lu]Lu-DOTA-TATE 靶向 SSR 受体，可显着延长晚期进展性胃肠胰系统神经内分泌肿瘤 (GEP-NET) 患者的无进展生存期。 PET/CT 是 NEN 多学科治疗的核心组成部分。考虑到增殖率较高或晚期转移性疾病的肿瘤需要更频繁的评估，建议采用可变的随访间隔。与 MRI 等其他成像方式的结合补充了 SSR-PET/CT，进一步提高了整体诊断准确性。要点：生长抑素受体-PET/CT（SSR-PET/CT）是指南推荐的高分化神经内分泌肿瘤（NET）影像学参考标准。 SSR-PET/CT 应作为 1 级或 2 级 NET（G1 或 G2）分期和治疗后重新分期的首选诊断影像。建议 NET G1 和 G2 采用可变随访间隔。具有较高增殖率或晚期转移性疾病的肿瘤需要更频繁的评估。© 2024。作者。

Neuroendocrine neoplasms (NEN) originate from the secretory cells of the neuroendocrine system, with the majority arising in the gastrointestinal tract and pancreas. Given the heterogeneity in the biological behavior and morphological differentiation of these tumors, advanced imaging techniques are crucial for supporting the suspected diagnosis, accurate staging, and monitoring therapy. As most well-differentiated NEN demonstrate overexpression of somatostatin receptors (SSR) on the cell surface, SSR-directed PET/CT is considered the reference standard for imaging of this particular entity. SSR-PET/CT should be the imaging method of choice in every NEN G1 or G2 and considered for re-staging after both potentially curative and non-curative surgeries. The extent of SSR expression is also crucial for determining a patient's eligibility for peptide receptor radionuclide therapy (PRRT). PRRT utilizes [177Lu]Lu-DOTA-TATE to target the SSR receptor and can significantly prolong progression-free survival in patients with advanced, progressive neuroendocrine tumor of the gastroenteropancreatic system (GEP-NET). PET/CT is a central component of the multidisciplinary management of NEN. Variable follow-up intervals are recommended, considering that tumors with higher proliferation rates or advanced metastatic disease require more frequent assessments. The combination with other imaging modalities, like MRI, complements SSR-PET/CT, further enhancing overall diagnostic accuracy. KEY POINTS: Somatostatin receptor-PET/CT (SSR-PET/CT) is the guideline-recommended reference standard for imaging well-differentiated neuroendocrine tumors (NET). SSR-PET/CT should be the diagnostic imaging of choice for staging and post-therapy re-staging of grade 1 or 2 NET (G1 or G2). Variable follow-up intervals are recommended for NET G1 and G2. Tumors with higher proliferation rates or advanced metastatic disease necessitate more frequent assessments.© 2024. The Author(s).