Managing Neuroendocrine Tumors in Interventional Radiology

Timestamps

1. 00:00Introduction
2. 02:09Specialization in Neuroendocrine Tumors
3. 06:32Patient Selection and Treatment Criteria
4. 10:40Grading and Treatment of Neuroendocrine Tumors
5. 16:09Systemic Therapy Options
6. 22:22Rebiopsy and Its Importance
7. 28:01Technical Aspects of Local Regional Therapies
8. 39:14Radioembolization: When and How
9. 43:33Segmentectomy and Multimodal Approaches
10. 45:22CapTemY90 Trial and Promising Results
11. 49:52Hormone Release During Local Regional Therapies
12. 53:12Combining Radioembolization with PRT
13. 56:12Thermal Ablation in Neuroendocrine Tumor Patients
14. 58:06Follow-Up Imaging and Tumor Markers
15. 01:02:40Updates from Nanets Conference
16. 01:05:08Collaborating Across Specialties
17. 01:07:56Managing High Tumor Burden Patients
18. 01:13:59Treating Carcinoid Heart Disease
19. 01:19:37Closing Remarks and Acknowledgments

More about this episode

The physicians start by discussing the intricacies of primary and metastatic neuroendocrine tumors, focusing on how treatment decisions are shaped by factors such as symptom burden, extent of disease requiring debulking, and symptom progression despite systemic therapy. Dr. DePietro shares insights from his clinical experience and emphasizes the critical role of interdisciplinary collaboration in optimizing patient outcomes. Dr. DePietro then shares his approach to using Y90 radioembolization in patients with biliary contraindications to TACE or bland embolization—such as those with prior Whipple surgery, sphincterotomy, or biliary stents—where the risk of hepatic abscess with ischemia-based therapies is higher. He also notes that patients who derive less than a year of benefit from prior TACE or bland embolization may be good candidates for radioembolization. The conversation also covers the role of thermal ablation in select patients with solitary lesions, and also touches on several key trials, including the ongoing CapTemY90 study.