Imaging Modalities for Neuroendocrine Tumors

The discussion among neuroendocrine tumor specialists highlighted major advances in imaging that have transformed diagnosis and disease management. Dr. Chauhan emphasized two main imaging approaches: anatomic imaging (CT and MRI) and molecular imaging (DOTATATE PET). Anatomic imaging remains essential for baseline staging, assessing disease burden, and monitoring treatment response—CT is preferred for chest imaging, while MRI or liver protocols are more sensitive for hepatic lesions. DOTATATE PET provides high sensitivity and specificity (≈95–97%) for detecting neuroendocrine tumors, even small or obscure lesions, and determines somatostatin receptor expression—crucial for selecting targeted therapies. When following indolent NET patients, a sudden change in disease biology may warrant repeating a DOTA scan to assess for loss of somatostatin receptor expression, indicating possible disease progression or transformation. This approach offers a non-invasive alternative to biopsy.