www.neuroendocrinecancer.org.uk
What tests or scans might I need to have before RLT?
Radioligand Therapy (RLT) is a targeted therapy, so it is crucial to determine whether your neuroendocrine tumour has the receptors needed for this treatment to be effective. For neuroendocrine tumours (NETs), including pheochromocytomas and paragangliomas, there are two main types of Radioligand Therapy: SSTR receptor radioligand therapy Radioactive iodine mIBG (131I-mIBG) radioligand therapy.
As mentioned previously, many, but not all, NETs have receptors on their cell surfaces that can be used to help diagnose and treat them.
For RLT to be a potential treatment for you, your medical team needs to check whether your tumours have receptors:
For SSTR RLT: an SSTR scan will be offered. For mIBG RLT: you may be offered an mIBG scan.
For those with Grade 2-3 NET - your medical team may also recommend an FDG- PET scan: which uses a radiotracer called fluorodeoxyglucose (FDG). Moderate to high grade NET cancer cells use up more energy than normal tissue (or low grade NETs), so absorb more glucose: they may have fewer or no SST receptors. By having both an SSTR scan and an FDG-PET scan, your medical team can gain a clearer understanding of how your NET may behave - and whether RLT is an appropriate treatment for you. If you have not already had a nuclear medicine scan to check for this—or have not had a recent one (within the previous 2–3 months)—this will be discussed with you. With your consent, the appropriate scan will be arranged. Other tests may include a physical assessment and blood tests to evaluate your overall health and ability for self-care. Blood tests will usually include a Full Blood Count, along with kidney and liver function tests. Tumour markers, such as Chromogranin A, may also be checked. If you have a functioning NET (one that produces excessive hormones or peptides), you may also have blood and/or urine tests to check your hormone levels.
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