Neuroendocrine neoplasms (NENs) represent a heterogenous group of tumors with significant inter- and intra-patient variability. Once considered to be rare, neuroendocrine neoplasms are being increasingly recognized through the advent of advanced diagnostic techniques, which may be contributing to the significant increase in the incidence and detection rate of these tumors. NENs can be classified into well differentiated and poorly differentiated neuroendocrine tumors (NETs) or neuroendocrine carcinomas (NECs). The proliferation rate of NETs can vary from Ki-67 1–55%. In addition, the SSTR expression can vary significantly. Because of this high “heterogeneity”, their detection and characterization have become essential to disease management, leading to dual-tracer imaging, most commonly with FDG- and SSTR-targeted PET/CT. Because of the complexity of the disease, the optimal treatment of patients depends on a combination of imaging, serological biomarkers, and clinical information. There remains a significant portion of patients who do not respond as anticipated, and the management of their disease remains challenging with current techniques, necessitating the refinement of our technologies and the development of new ones. In addition to new biological targets, improved peptide vector targeting for the somatostatin receptor needs further development. This review aims to evaluate the existing imaging techniques utilized in the diagnosis, assessment, and treatment of NENs, as well as the emerging radiopharmaceuticals and technologies, which will expand our imaging repertoire as well as our management options.
神经内分泌肿瘤（NENs）是一组具有显著患者间及患者内异质性的肿瘤。随着先进诊断技术的发展，这类曾被视作罕见的肿瘤正日益受到重视，这可能是其发病率和检出率显著上升的原因之一。神经内分泌肿瘤可分为分化良好与分化差的神经内分泌瘤（NETs）或神经内分泌癌（NECs）。NETs的增殖指数Ki-67值可在1%至55%之间波动，其生长抑素受体表达水平亦存在显著差异。基于这种高度"异质性"，肿瘤的检测与特征分析已成为疾病管理的核心环节，由此催生了以FDG和SSTR为靶点的双示踪剂PET/CT成像技术。鉴于疾病的复杂性，最佳治疗方案需综合影像学、血清生物标志物及临床信息制定。目前仍有相当比例患者未能获得预期疗效，现有技术下的疾病管理仍面临挑战，这要求我们持续优化现有技术并开发新方法。除探索新的生物靶点外，针对生长抑素受体的肽类载体靶向技术也亟待进一步发展。本文旨在系统评述当前用于神经内分泌肿瘤诊断、评估及治疗的影像技术，并探讨新兴放射性药物与技术的进展，这些创新将拓展我们的影像学手段并丰富临床管理策略。
肿瘤(癌症)患者之家