Author:

Abstract:

Over the last few years progress has been made in the management of neuroendocrine tumours (NET). This includes a clearer characterisation, a more specific and therapeutically relevant diagnosis, as well as improved treatments. Still, randomised trials remain scarce as the tumors are rather uncommon. Two case reports detail and critically evaluate the most recent guidelines - and more specifically the role of somatostatin receptor scintigraphy (SRS) - for the diagnosis and treatment of NET of the gastrointestinal tract. The UKNET (United Kingdom Neuroendocrine Tumour Group) has proposed the following recommendations concerning the imaging of gastroenteropancreatic NET. For detecting a primary tumor, a multimodal approach is most suitable. It may include CT, MRI, SRS, ultrasound, endoscopy, digital subtraction angiography and venous sampling. For assessing metastases, SRS is the most sensitive modality. After the resection of a primary tumor, SRS may be indicated for follow-up. SRS has also a considerable value during the treatment of NET. Peptide receptor mediated radionuclide therapy is a beneficial palliative option for symptomatic patients with inoperable or metastatic tumors, the rule being to administer a radionuclide therapy only to patients with an increased uptake of the corresponding imaging agent as well. These guidelines are not intended to constitute a rigid protocol but to form the basis for improving the quality standards of the treatment of these patients.