Pancreatic NENs are classified into three grading subgroups on the basis of mitotic activity and Ki-67 index. In 2010, the WHO updated its classification of GEP NENs. NENs of the lungs, also called pulmonary carcinoids, are classified according to their mitotic count rate and the presence of necrosis. The World Health Organization (WHO) uses mitotic count and the level of the nuclear protein Ki-67, which is associated with cellular proliferation, to classify GEP neuroendocrine neoplasms (NENs). Ģ017 World Health Organization Classification of Neuroendocrine Tumors and Neuroendocrine Carcinoma According to the SNMMI appropriate use criteria guidelines, SSTR PET should be the preferred imaging modality for initial diagnosis, selection of patients for peptide receptor radionuclide therapy (PRRT), and localization of unknown primaries. In the recently updated National Comprehensive Cancer Network (NCCN) guidelines, 68Ga-DOTA-DPhe1-Tyr3-octreotate (DOTATATE) PET/CT has been added as an appropriate evaluation tool along with site-specific anatomic imaging using multiphase CT, multiphase MRI, or endoscopic ultrasound. According to the Society of Nuclear Medicine and Molecular Imaging (SNMMI) appropriateness use criteria, SSTR PET should replace 111In-pentetreotide scintigraphy in all instances in which SSTR scintigraphy is being used. SSTR-based 68Ga-tetraazacyclododecanetetraacetic acid (DOTA)–peptide PET/CT is an exciting imaging modality that has shown significant advantages over conventional imaging in diagnosis and management of NETs. found a 6.4-fold increase in age-adjusted incidence from 1973 to 2012 (6.98 per 100,000 patients). In a retrospective population-based study, Dasari et al. In recent years, the incidence and prevalence of NETs have increased, partly because of early detection and longer survival from improved therapy. These tumors show overexpression of somatostatin receptors (SSTRs) on their cell membrane, more frequently type 2. Neuroendocrine tumors (NETs) are a rare, heterogeneous group of tumors, most commonly arising in the gastroenteropancreatic (GEP) tract and lungs.
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