Zusammenfassung
Hintergrund
Neuroendokrine Neoplasien (NEN) sind ein heterogenes Erkrankungsbild, und in den letzten Jahren ist eine zunehmende Inzidenz zu beobachten.
Fragestellung
Überblick über Häufigkeit, Symptomatik, allgemeine Diagnostik, Stadieneinteilung, Bildgebung und prognostische Faktoren und deren Einfluss auf das Krankheitsmanagement.
Material und Methode
Durchsicht der aktuellen Literatur und Guidelines sowie Empfehlungen von Expertinnen und Experten.
Ergebnisse
NEN sind vornehmlich im Gastrointestinaltrakt zu finden. Ihre Inzidenz ist in den letzten Jahren a. e. durch bessere Untersuchungstechniken (funktionelle Schnittbildgebung) gestiegen. Zu den klinischen Charakteristika zählen u. a. Hormonexzesssyndrome, wie das Karzinoidsyndrom. Zur Diagnostik kommen Labormarker wie Chromogranin A zum Einsatz, dem folgen endoskopische und endosonographische Verfahren, u. a. zur Biopsiegewinnung. Zudem sollte eine Ausbreitungsdiagnostik mittels kontrastgestützter Computertomographie (CT)/Magnetresonanztomographie (MRT) oder Somatostatinrezeptor(SSTR)-Positronenemissionstomographie(PET)/CT erfolgen. Relevant für die Prognose sind u. a. der Ki67-Proliferationsindex, Art des Primärtumors und das Stadium. Eine Resektion ist im kurativen Setting die Erstlinientherapie. In differenzierten, metastasierten NEN kommen SSTR-gerichtete Therapieoptionen zum Einsatz, während in dedifferenzierten, metastasierten NEN eine klassische Chemotherapie notwendig ist.
Schlussfolgerung
Als heterogene Erkrankungsgruppe wird bei NEN ein breites Portfolio aus diagnostischen Verfahren vorgehalten; diese verbesserte Diagnostik führte auch wahrscheinlich zu einer erhöhten Inzidenz in den letzten Jahren. Prognosebestimmend sind u. a. Ki67 und die Größe/Art des Primarius. Diese Faktoren haben auch Einfluss auf das weitere Management.
Abstract
Background
Neuroendocrine neoplasms (NEN) are heterogenous with an increasing incidence in recent years.
Objectives
Overview on incidence, symptoms, diagnostics, grading, imaging and prognostic determinants, including factors having an impact on therapeutic management.
Methods
Review on current literature, including original articles, reviews, guidelines and expert opinions.
Results
NEN are mainly located in the gastrointestinal tract and their incidence has increased in recent years, mainly due to improved diagnostics, e.g., cross-sectional imaging. Clinical characteristics include hormone excess syndromes (carcinoid syndrome). Laboratory markers such as chromogranin A are commonly used as part of routine diagnostics, followed by endoscopic and endosonographic procedures, which also allow biopsies to be obtained. Tumor spread can be determined by contrast-enhanced computed tomography/magnetic resonance imaging (CT/MRI) or somatostatin receptor (SSRT)-PET/CT (positron emission tomography). Prognostic factors include Ki67 index, type, and grading. Resection with curative intent is the therapy of choice. In a metastasized setting, SSRT-directed treatment approaches are favored, while in dedifferentiated NEN, conventional chemotherapy is needed.
Conclusion
A broad diagnostic armamentarium can be offered to NEN patients and the improved diagnostic procedures have most likely caused a raising incidence in recent years. Among others, prognostic factors are Ki67 and NEN subtypes; these clinical determinants also have an impact on patient management.
Literatur
Hallet J, Law CH, Cukier M, Saskin R, Liu N, Singh S (2015) Exploring the rising incidence of neuroendocrine tumors: a population-based analysis of epidemiology, metastatic presentation, and outcomes. Cancer 121(4):589–597
Dasari A, Shen C, Halperin D, Zhao B, Zhou S, Xu Y et al (2017) Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol 3(10):1335–1342
Chin JL, O’Toole D (2017) Diagnosis and management of upper gastrointestinal neuroendocrine tumors. Clin Endosc 50(6):520–529
Hofland J, Falconi M, Christ E, Castano JP, Faggiano A, Lamarca A et al (2023) European Neuroendocrine Tumor Society 2023 guidance paper for functioning pancreatic neuroendocrine tumour syndromes. J Neuroendocrinol 35(8):e13318
Werner RA, Weich A, Kircher M, Solnes LB, Javadi MS, Higuchi T et al (2018) The theranostic promise for Neuroendocrine Tumors in the late 2010s—Where do we stand, where do we go? Theranostics 8(22):6088–6100
Yao JC, Hassan M, Phan A, Dagohoy C, Leary C, Mares JE et al (2008) One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 26(18):3063–3072
Cives M, Strosberg JR (2018) Gastroenteropancreatic Neuroendocrine Tumors. CA Cancer J Clin 68(6):471–487
Schimmack S, Svejda B, Lawrence B, Kidd M, Modlin IM (2011) The diversity and commonalities of gastroenteropancreatic neuroendocrine tumors. Langenbecks Arch Surg 396(3):273–298
Oronsky B, Ma PC, Morgensztern D, Carter CA (2017) Nothing But NET: a review of Neuroendocrine Tumors and Carcinomas. Neoplasia 19(12):991–1002
Gut P, Komarowska H, Czarnywojtek A, Waligorska-Stachura J, Baczyk M, Ziemnicka K et al (2015) Familial syndromes associated with neuroendocrine tumours. Contemp Oncol (pozn) 19(3):176–183
Korse CM, Taal BG, van Velthuysen ML, Visser O (2013) Incidence and survival of neuroendocrine tumours in the Netherlands according to histological grade: experience of two decades of cancer registry. Eur J Cancer 49(8):1975–1983
Takayanagi D, Cho H, Machida E, Kawamura A, Takashima A, Wada S et al (2022) Update on epidemiology, diagnosis, and biomarkers in gastroenteropancreatic neuroendocrine neoplasms. Cancers (basel) 14(5)
Fraenkel M, Faggiano A, Valk GD (2015) Epidemiology of Neuroendocrine Tumors. Front Horm Res 44:1–23
Scherubl H, Streller B, Stabenow R, Herbst H, Hopfner M, Schwertner C et al (2013) Clinically detected gastroenteropancreatic neuroendocrine tumors are on the rise: epidemiological changes in Germany. World J Gastroenterol 19(47):9012–9019
Genus TSE, Bouvier C, Wong KF, Srirajaskanthan R, Rous BA, Talbot DC et al (2019) Impact of neuroendocrine morphology on cancer outcomes and stage at diagnosis: a UK nationwide cohort study 2013–2015. Br J Cancer 121(11):966–972
Gudmundsdottir H, Moller PH, Jonasson JG, Bjornsson ES (2019) Gastroenteropancreatic neuroendocrine tumors in Iceland: a population-based study. Scand J Gastroenterol 54(1):69–75
Das S, Dasari A (2021) Epidemiology, Incidence, and Prevalence of Neuroendocrine Neoplasms: are there Global Differences? Curr Oncol Rep 23(4):43
Ito T, Igarashi H, Nakamura K, Sasano H, Okusaka T, Takano K et al (2015) Epidemiological trends of pancreatic and gastrointestinal neuroendocrine tumors in Japan: a nationwide survey analysis. J Gastroenterol 50(1):58–64
Masui T, Ito T, Komoto I, Uemoto S, Group JPS (2020) Recent epidemiology of patients with gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NEN) in Japan: a population-based study. Bmc Cancer 20(1):1104
Chang JS, Chen LT, Shan YS, Chu PY, Tsai CR, Tsai HJ (2021) An updated analysis of the epidemiologic trends of neuroendocrine tumors in Taiwan. Sci Rep 11(1):7881
Gastrointestinal Pathology Study Group of Korean Society of P, Cho MY, Kim JM, Sohn JH, Kim MJ, Kim KM et al (2012) Current trends of the incidence and pathological diagnosis of Gastroenteropancreatic Neuroendocrine Tumors (GEP-NETs) in Korea 2000–2009: multicenter study. Cancer Res Treat 44(3):157–165
Zarate X, Williams N, Herrera MF (2012) Pancreatic incidentalomas. Best Pract Res Clin Endocrinol Metab 26(1):97–103
Kessel E, Naparst M, Alpert N, Diaz K, Ahn E, Wolin E et al (2021) Racial differences in Gastroenteropancreatic Neuroendocrine Tumor treatment and Survival in the United States. Pancreas 50(1):29–36
Modlin IM, Moss SF, Chung DC, Jensen RT, Snyderwine E (2008) Priorities for improving the management of gastroenteropancreatic neuroendocrine tumors. J Natl Cancer Inst 100(18):1282–1289
Pavel M, Oberg K, Falconi M, Krenning EP, Sundin A, Perren A et al (2020) Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 31(7):844–860
Modlin IM, Kidd M, Latich I, Zikusoka MN, Shapiro MD (2005) Current status of gastrointestinal carcinoids. Gastroenterology 128(6):1717–1751
Modlin IM, Oberg K, Chung DC, Jensen RT, de Herder WW, Thakker RV et al (2008) Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol 9(1):61–72
Hallet J, Davis LE, Mahar AL, Law CHL, Isenberg-Grzeda E, Bubis LD et al (2019) Patterns of Symptoms Burden in Neuroendocrine Tumors: a population-based analysis of prospective patient-reported outcomes. Oncologist 24(10):1384–1394
Vinik AI, Chaya C (2016) Clinical Presentation and Diagnosis of Neuroendocrine Tumors. Hematol Oncol Clin North Am 30(1):21–48
Hofland J, Kaltsas G, de Herder WW (2020) Advances in the Diagnosis and Management of Well-Differentiated Neuroendocrine Neoplasms. Endocr Rev 41(2):371–403
Falconi M, Plockinger U, Kwekkeboom DJ, Manfredi R, Korner M, Kvols L et al (2006) Well-differentiated pancreatic nonfunctioning tumors/carcinoma. Neuroendocrinology 84(3):196–211
Liakakos T, Roukos DH (2011) Everolimus and sunitinib: from mouse models to treatment of pancreatic neuroendocrine tumors. Future Oncol 7(9):1025–1029
Thakker RV (2014) Multiple endocrine neoplasia type 1 (MEN1) and type 4 (MEN4). Mol Cell Endocrinol 386(1–2:2–15
Kaelin WG Jr. (2008) The von Hippel-Lindau tumour suppressor protein: O2 sensing and cancer. Nat Rev Cancer 8(11):865–873
Dworakowska D, Grossman AB (2009) Are neuroendocrine tumours a feature of tuberous sclerosis? a systematic review. Endocr Relat Cancer 16(1):45–58
Rogers A, Wang LM, Karavitaki N, Grossman AB (2015) Neurofibromatosis Type 1 and pancreatic islet cell tumours: an association which should be recognized. Qjm 108(7):573–576
Lawrence B, Gustafsson BI, Kidd M, Pavel M, Svejda B, Modlin IM (2011) The clinical relevance of chromogranin a as a biomarker for gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am 40(1):111–134
Yang X, Yang Y, Li Z, Cheng C, Yang T, Wang C et al (2015) Diagnostic value of circulating chromogranin a for neuroendocrine tumors: a systematic review and meta-analysis. PLoS ONE 10(4):e124884
Kölby L, Bernhardt P, Swärd C, Johanson V, Ahlman H, Forssell-Aronsson E et al (2004) Chromogranin a as a determinant of midgut carcinoid tumour volume. Regul Pept 120(1–3:269–273
Stridsberg M, Eriksson B, Fellström B, Kristiansson G, Tiensuu Janson E (2007) Measurements of chromogranin B can serve as a complement to chromogranin A. Regul Pept 139(1–3:80–83
Takiyyuddin MA, Cervenka JH, Hsiao RJ, Barbosa JA, Parmer RJ, O’Connor DT (1990) Chromogranin A. Storage and release in hypertension. Hypertension 15(3):237–246
Brabander T, van der Zwan WA, Teunissen JJM, Kam BLR, de Herder WW, Feelders RA et al (2017) Pitfalls in the response evaluation after peptide receptor radionuclide therapy with [(177)Lu-DOTA(0),Tyr(3)]octreotate. Endocr Relat Cancer 24(5):243–251
Tormey WP, FitzGerald RJ (1995) The clinical and laboratory correlates of an increased urinary 5‑hydroxyindoleacetic acid. Postgrad Med J 71(839):542–545
Ewang-Emukowhate M, Nair D, Caplin M (2019) The role of 5‑hydroxyindoleacetic acid in neuroendocrine tumors: the journey so far. Int J Endocr Oncol 6(2):IJE17
Kanakis G, Kaltsas G (2012) Biochemical markers for gastroenteropancreatic neuroendocrine tumours (GEP-NETs). Best Pract Res Clin Gastroenterol 26(6):791–802
Bajetta E, Ferrari L, Martinetti A, Celio L, Procopio G, Artale S et al (1999) Chromogranin A, neuron specific enolase, carcinoembryonic antigen, and hydroxyindole acetic acid evaluation in patients with neuroendocrine tumors. Cancer 86(5):858–865
Seydafkan S, Coppola D (2016) Neuroendocrine tumor classification systems: staging. In: Nasir A, Coppola D (Hrsg) Neuroendocrine Tumors: Review of Pathology, Molecular and Therapeutic Advances. Springer New York, New York, NY, S 21–30
Committee ASP, Early DS, Ben-Menachem T, Decker GA, Evans JA, Fanelli RD et al (2012) Appropriate use of GI endoscopy. Gastrointest Endosc 75(6):1127–1131
Esposito G, Angeletti S, Cazzato M, Galli G, Conti L, Di Giulio E et al (2020) Narrow band imaging characteristics of gastric polypoid lesions: a single-center prospective pilot study. Eur J Gastroenterol Hepatol 32(6):701–705
Panzuto F, Ramage J, Pritchard DM, van Velthuysen MF, Schrader J, Begum N et al (2023) European Neuroendocrine Tumor Society (ENETS) 2023 guidance paper for gastroduodenal neuroendocrine tumours (NETs) G1–G3. J Neuroendocrinol 35(8):e13306
Puli SR, Kalva N, Bechtold ML, Pamulaparthy SR, Cashman MD, Estes NC et al (2013) Diagnostic accuracy of endoscopic ultrasound in pancreatic neuroendocrine tumors: a systematic review and meta analysis. World J Gastroenterol 19(23):3678–3684
Hofland J, Falconi M, Christ E, Castaño JP, Faggiano A, Lamarca A et al (2023) European Neuroendocrine Tumor Society 2023 guidance paper for functioning pancreatic neuroendocrine tumour syndromes. J Neuroendocrinol 35(8):e13318
Ramage JK, De Herder WW, Delle Fave G, Ferolla P, Ferone D, Ito T et al (2016) ENETS Consensus Guidelines Update for Colorectal Neuroendocrine Neoplasms. Neuroendocrinology 103(2):139–143
Park SB, Kim DJ, Kim HW, Choi CW, Kang DH, Kim SJ et al (2017) Is endoscopic ultrasonography essential for endoscopic resection of small rectal neuroendocrine tumors? World J Gastroenterol 23(11):2037–2043
Toumpanakis C, Kim MK, Rinke A, Bergestuen DS, Thirlwell C, Khan MS et al (2014) Combination of cross-sectional and molecular imaging studies in the localization of gastroenteropancreatic neuroendocrine tumors. Neuroendocrinology 99(2):63–74
Sundin A, Arnold R, Baudin E, Cwikla JB, Eriksson B, Fanti S et al (2017) ENETS consensus guidelines for the standards of care in neuroendocrine tumors: radiological, nuclear medicine & hybrid imaging. Neuroendocrinology 105(3):212–244
Walczyk J, Sowa-Staszczak A (2019) Diagnostic imaging of gastrointestinal neuroendocrine neoplasms with a focus on ultrasound. J Ultrason 19(78):228–235
El Gabry M, Arends S, Shehada SE, Lahner H, Kamler M, Wendt D et al (2023) Hedinger syndrome-lessons learnt: a single-center experience. J Cardiovasc Dev Dis 10(10)
Dromain C, de Baere T, Lumbroso J, Caillet H, Laplanche A, Boige V et al (2005) Detection of liver metastases from endocrine tumors: a prospective comparison of somatostatin receptor scintigraphy, computed tomography, and magnetic resonance imaging. J Clin Oncol 23(1):70–78
Hayoz R, Vietti-Violi N, Duran R, Knebel JF, Ledoux JB, Dromain C (2020) The combination of hepatobiliary phase with Gd-EOB-DTPA and DWI is highly accurate for the detection and characterization of liver metastases from neuroendocrine tumor. Eur Radiol 30(12):6593–6602
Rinke A, Ambrosini V, Dromain C, Garcia-Carbonero R, Haji A, Koumarianou A et al (2023) European Neuroendocrine Tumor Society (ENETS) 2023 guidance paper for colorectal neuroendocrine tumours. J Neuroendocrinol 35(6):e13309
Reubi JC, Kvols LK, Waser B, Nagorney DM, Heitz PU, Charboneau JW et al (1990) Detection of somatostatin receptors in surgical and percutaneous needle biopsy samples of carcinoids and islet cell carcinomas. Cancer Res 50(18):5969–5977
Hope TA, Bergsland EK, Bozkurt MF, Graham M, Heaney AP, Herrmann K et al (2018) Appropriate use criteria for somatostatin receptor PET imaging in neuroendocrine tumors. J Nucl Med 59(1):66–74
Kos-Kudła B, Castaño JP, Denecke T, Grande E, Kjaer A, Koumarianou A, et al European Neuroendocrine Tumour Society (2023) (ENETS) 2023 guidance paper for nonfunctioning pancreatic neuroendocrine tumours. J Neuroendocrinol 35(12):e13343
Chan DL, Hoang J, Roach PJ, Arena J, Bailey DL, Nevell D et al (2020) Routine Early 68Ga-DOTATATE positron emission tomography has low yield after resection of appendiceal neuroendocrine neoplasms. Pancreas 49(7):891–896
Kaltsas G, Walter T, Knigge U, Toumpanakis C, Santos AP, Begum N et al (2023) European Neuroendocrine Tumor Society (ENETS) 2023 guidance paper for appendiceal neuroendocrine tumours (aNET). J Neuroendocrinol 35(10):e13332
Ambrosini V, Caplin M, Castaño JP, Christ E, Denecke T, Deroose CM et al (2024) Use and perceived utility of [(18) F]FDG PET/CT in neuroendocrine neoplasms: a consensus report from the European Neuroendocrine Tumor Society (ENETS) advisory board meeting 2022. J Neuroendocrinol 36(1):e13359
Kosmala A, Serfling SE, Schlotelburg W, Lindner T, Michalski K, Schirbel A et al (2023) Impact of 68 Ga-FAPI-04 PET/CT on staging and therapeutic management in patients with digestive system tumors. Clin Nucl Med 48(1):35–42
Janson ET, Holmberg L, Stridsberg M, Eriksson B, Theodorsson E, Wilander E et al (1997) Carcinoid tumors: analysis of prognostic factors and survival in 301 patients from a referral center. Ann Oncol 8(7):685–690
Tao Z, Xue R, Wei Z, Qin L, Bai R, Liu N et al (2023) The assessment of Ki-67 for prognosis of gastroenteropancreatic neuroendocrine neoplasm patients: a systematic review and meta-analysis. Transl Cancer Res 12(8):1980–1991
Busico A, Maisonneuve P, Prinzi N, Pusceddu S, Centonze G, Garzone G et al (2020) Gastroenteropancreatic high-grade neuroendocrine neoplasms: histology and molecular analysis, two sides of the same coin. Neuroendocrinology 110(7–8:616–629
Panzuto F, Merola E, Rinzivillo M, Partelli S, Campana D, Iannicelli E et al (2014) Advanced digestive neuroendocrine tumors: metastatic pattern is an independent factor affecting clinical outcome. Pancreas 43(2:212–218
Lawrence B, Gustafsson BI, Chan A, Svejda B, Kidd M, Modlin IM (2011) The epidemiology of gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am 40(1):1–18 (vii)
Man D, Wu J, Shen Z, Zhu X (2018) Prognosis of patients with neuroendocrine tumor: a SEER database analysis. Cancer Manag Res 10:5629–5638
Norlen O, Stalberg P, Oberg K, Eriksson J, Hedberg J, Hessman O et al (2012) Long-term results of surgery for small intestinal neuroendocrine tumors at a tertiary referral center. World J Surg 36(6):1419–1431
Exner S, Prasad V, Wiedenmann B, Grotzinger C (2018) Octreotide does not inhibit proliferation in five neuroendocrine tumor cell lines. Front Endocrinol (lausanne) 9:146
Gunther T, Tulipano G, Dournaud P, Bousquet C, Csaba Z, Kreienkamp HJ et al (2018) International Union of basic and clinical pharmacology. CV. Somatostatin Receptors: structure, function, ligands, and new nomenclature. Pharmacol Rev 70(4):763–835
Saslow SB, O’Brien MD, Camilleri M, von der Ohe M (1997) Homburger HA, Klee GG, et al. Octreotide inhibition of flushing and colonic motor dysfunction in carcinoid syndrome. Am J Gastroenterol 92(12):2250–2256
Panzuto F, Rinzivillo M, Spada F, Antonuzzo L, Ibrahim T, Campana D et al (2017) Everolimus in pancreatic neuroendocrine carcinomas G3. Pancreas 46(3):302–305
Pellat A, Dreyer C, Couffignal C, Walter T, Lombard-Bohas C, Niccoli P et al (2018) Clinical and biomarker evaluations of sunitinib in patients with grade 3 digestive neuroendocrine neoplasms. Neuroendocrinology 107(1):24–31
Mitry E, Baudin E, Ducreux M, Sabourin JC, Rufie P, Aparicio T et al (1999) Treatment of poorly differentiated neuroendocrine tumours with etoposide and cisplatin. Br J Cancer 81(8):1351–1355
Garcia-Carbonero R, Sorbye H, Baudin E, Raymond E, Wiedenmann B, Niederle B et al (2016) ENETS Consensus Guidelines for High-Grade Gastroenteropancreatic Neuroendocrine Tumors and Neuroendocrine Carcinomas. Neuroendocrinology 103(2):186–194
Nisa L, Savelli G, Giubbini R (2011) Yttrium-90 DOTATOC therapy in GEP-NET and other SST2 expressing tumors: a selected review. Ann Nucl Med 25(2):75–85
Strosberg J, El-Haddad G, Wolin E, Hendifar A, Yao J, Chasen B et al (2017) Phase 3 Trial of (177)Lu-Dotatate for Midgut Neuroendocrine Tumors. N Engl J Med 376(2):125–135
Strosberg J, Wolin E, Chasen B, Kulke M, Bushnell D, Caplin M et al (2018) Health-related quality of life in patients with progressive midgut neuroendocrine tumors treated with (177)Lu-Dotatate in the Phase III NETTER‑1 trial. J Clin Oncol 36(25):2578–2584
Strosberg JR, Caplin ME, Kunz PL, Ruszniewski PB, Bodei L, Hendifar A et al (2021) (177)Lu-Dotatate plus long-acting octreotide versus high-dose long-acting octreotide in patients with midgut neuroendocrine tumours (NETTER-1): final overall survival and long-term safety results from an open-label, randomised, controlled, phase 3 trial. Lancet Oncol 22(12):1752–1763
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Interessenkonflikt
R.A. Werner hat Rednerhonorare von Novartis/AAA und PentixaPharm erhalten und war im Advisory Board von Novartis/AAA und Bayer tätig. AW hat Rednerhonorare von Novartis/AAA erhalten und war im Advisory Board von Novartis/AAA tätig. P.E. Hartrampf, S.E. Serfling, T. Higuchi, J. Bojunga und A. Weich geben an, dass kein Interessenkonflikt besteht.
Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
Additional information
Hinweis des Verlags
Der Verlag bleibt in Hinblick auf geografische Zuordnungen und Gebietsbezeichnungen in veröffentlichten Karten und Institutsadressen neutral.
Gleichwertige Autorenschaft: Dr. med. Alexander Weich, Prof. Dr. med. Rudolf A. Werner.
QR-Code scannen & Beitrag online lesen
Rights and permissions
About this article
Cite this article
Hartrampf, P.E., Serfling, S.E., Higuchi, T. et al. Klinische Bedeutung von neuroendokrinen Tumoren. Radiologie 64, 536–545 (2024). https://doi.org/10.1007/s00117-024-01315-y
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00117-024-01315-y
Schlüsselwörter
- Somatostatinrezeptor
- Neuroendokrine Neoplasie
- Positronen-Emissions-Tomographie
- Peptidradiorezeptortherapie
- Theranostics