Radioguided Surgery for Gastroenteropancreatic Neuroendocrine Tumours: a Systematic Literature Review.
Diagnostic techniques
Neuroendocrine tumours/surgery
Radioisotope
Radiopharmaceutical
Journal
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
ISSN: 1873-4626
Titre abrégé: J Gastrointest Surg
Pays: United States
ID NLM: 9706084
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
26
02
2021
accepted:
07
08
2021
pubmed:
11
9
2021
medline:
30
12
2021
entrez:
10
9
2021
Statut:
ppublish
Résumé
Radioguided surgery (RGS) for gastroenteropancreatic neuroendocrine tumours (GEP-NETs) has been suggested as a way to improve intraoperative lesion detection. This systematic literature review of reports of the use of RGS for GEP-NETs was performed to determine if there is a benefit. A literature search was conducted using Google Scholar and PubMed, and snowballing from any relevant literature. Full-text studies were included if they were published in the English language and reported outcomes of RGS on human subjects with GEP-NETs. Qualitative data synthesis was performed. Twenty-six papers including a total of 209 patients were included. The tracers used were predominantly indium-111 pentetreotide, gallium-68 DOTA-peptides, and technetium-99m EDDA/HYNIC-peptides. Heterogeneous protocols make comparisons difficult, but most papers reported a benefit from the use of RGS in tumours in the gastrointestinal tract; utility in localisation of pancreatic tumours was less clear. Time between tracer administration and operation varied: from 16 h to 8 days with indium-111, 0-24 h with technetium-99m, and 19-193 min with gallium-68. Eight teams reported the thresholding technique used for discrimination-four used a ratio, four statistical methods, and one looked at the sensitivity and specificity of different cut-offs. Six teams performed follow-up of 24 patients (three pancreas, eight gastrinoma, 13 gastrointestinal tract) for between 3 months and 3 years. Two patients relapsed (one pancreas, one gastrinoma) between 6 and 12 months post-surgery. RGS appears to aid in localisation of gastrointestinal NETs, but the benefit is more equivocal in pancreatic NETs. Further work into outcomes is warranted.
Sections du résumé
BACKGROUND
Radioguided surgery (RGS) for gastroenteropancreatic neuroendocrine tumours (GEP-NETs) has been suggested as a way to improve intraoperative lesion detection. This systematic literature review of reports of the use of RGS for GEP-NETs was performed to determine if there is a benefit.
METHODS
A literature search was conducted using Google Scholar and PubMed, and snowballing from any relevant literature. Full-text studies were included if they were published in the English language and reported outcomes of RGS on human subjects with GEP-NETs. Qualitative data synthesis was performed.
RESULTS
Twenty-six papers including a total of 209 patients were included. The tracers used were predominantly indium-111 pentetreotide, gallium-68 DOTA-peptides, and technetium-99m EDDA/HYNIC-peptides. Heterogeneous protocols make comparisons difficult, but most papers reported a benefit from the use of RGS in tumours in the gastrointestinal tract; utility in localisation of pancreatic tumours was less clear. Time between tracer administration and operation varied: from 16 h to 8 days with indium-111, 0-24 h with technetium-99m, and 19-193 min with gallium-68. Eight teams reported the thresholding technique used for discrimination-four used a ratio, four statistical methods, and one looked at the sensitivity and specificity of different cut-offs. Six teams performed follow-up of 24 patients (three pancreas, eight gastrinoma, 13 gastrointestinal tract) for between 3 months and 3 years. Two patients relapsed (one pancreas, one gastrinoma) between 6 and 12 months post-surgery.
CONCLUSIONS
RGS appears to aid in localisation of gastrointestinal NETs, but the benefit is more equivocal in pancreatic NETs. Further work into outcomes is warranted.
Identifiants
pubmed: 34506015
doi: 10.1007/s11605-021-05115-w
pii: 10.1007/s11605-021-05115-w
pmc: PMC8654712
doi:
Types de publication
Journal Article
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
3244-3257Informations de copyright
© 2021. The Author(s).
Références
Endokrynol Pol. 2018;69(3):313-317
pubmed: 29952421
J Am Coll Surg. 2015 Aug;221(2):300-8
pubmed: 26206636
Open Med. 2009;3(3):e123-30
pubmed: 21603045
J Gastrointest Surg. 2012 Mar;16(3):635-40
pubmed: 22105237
Gastric Cancer. 2008;11(2):123-6
pubmed: 18595020
Nucl Med Rev Cent East Eur. 2014;17(2):110-4
pubmed: 25088113
J Surg Oncol. 2005 Sep 1;91(3):209-11
pubmed: 16118779
J Nucl Med. 1998 Jul;39(7):1155-60
pubmed: 9669386
Endocrinol Metab Clin North Am. 2011 Mar;40(1):1-18, vii
pubmed: 21349409
Nucl Med Biol. 2003 Apr;30(3):253-60
pubmed: 12745016
Ann Nucl Med. 2005 Oct;19(7):611-5
pubmed: 16363628
Int J Surg Case Rep. 2011;2(4):49-50
pubmed: 26902550
Ann ICRP. 2015 Jul;44(2 Suppl):7-321
pubmed: 26069086
Lancet Oncol. 2008 Jan;9(1):61-72
pubmed: 18177818
J Surg Oncol. 2007 Sep 15;96(4):309-15
pubmed: 17726664
Cancer. 1997 Dec 15;80(12 Suppl):2490-4
pubmed: 9406700
Br J Cancer. 1996 Mar;73(6):770-5
pubmed: 8611378
Eur J Nucl Med. 2001 Oct;28(10):1456-62
pubmed: 11685487
Recent Results Cancer Res. 2013;194:487-96
pubmed: 22918778
Q J Nucl Med. 2000 Mar;44(1):59-67
pubmed: 10932602
Semin Surg Oncol. 1998 Dec;15(4):239-44
pubmed: 9829380
Nucl Med Commun. 2008 Apr;29(4):311-7
pubmed: 18317293
Eur J Nucl Med Mol Imaging. 2008 Aug;35(8):1577
pubmed: 18566820
Eur J Nucl Med Mol Imaging. 2007 Oct;34(10):1545-55
pubmed: 17653543
Ann Surg Oncol. 2015 Dec;22 Suppl 3:S676-82
pubmed: 26350374
Clin Nucl Med. 2012 Feb;37(2):142-7
pubmed: 22228336
Nucl Med Rev Cent East Eur. 2017;20(1):49-56
pubmed: 28218348
World J Surg Oncol. 2007 Jun 07;5:65
pubmed: 17555587
Clin Nucl Med. 2005 May;30(5):308-11
pubmed: 15827397
Nuklearmedizin. 2009;48(5):N50-1
pubmed: 20512197
Eur J Nucl Med Mol Imaging. 2006 Oct;33(10):1123-33
pubmed: 16721571
World J Gastroenterol. 2008 Sep 21;14(35):5377-84
pubmed: 18803349
Rev Esp Med Nucl Imagen Mol. 2014 Nov-Dec;33(6):358-65
pubmed: 25107596
Radiographics. 2007 Sep-Oct;27(5):1355-69
pubmed: 17848696
Tumori. 2002 May-Jun;88(3):S41-3
pubmed: 12365386
Am J Nucl Med Mol Imaging. 2018 Oct 20;8(5):311-331
pubmed: 30510849
JAMA Surg. 2019 Jan 1;154(1):40-45
pubmed: 30267071