Utility of radioguided surgery in the intraoperative localization of neuroendocrine tumors: Report of 3 cases.

Neuroendocrine tumors (NETs) represent a heterogeneous group of neoplasms originating from neuroendocrine cells. Overexpression of somatostatin receptors is typically correlated with tumor differentiation. Localization and characterization of the primary tumor are essential, as radical surgery remains the treatment of choice for resectable disease. Additionally, identifying metastatic disease and assessing its extent are crucial for disease staging and monitoring response aimed at reducing total tumor volume. Radioguided surgery based on the ability to detect somatostatin receptor overexpression, is a valuable tool that aids in the identification of microscopic and occult endocrine tumors. In this context, we present three patients who achieved improved outcomes due to enhanced detection and identification of previously indeterminate or undetected lesions on prior imaging or even the detection of tumors that were not easily visualized without radioguided assistance. Complete tumor removal is a key prognostic factor in patients with NETs, improving quality of life and reducing the risk of tumor recurrence or locorregional metastasis. Achieving R0 or R1 resections has been associated with better survival outcomes. The successful implementation of radioguided surgery for NETs requires a multidisciplinary approach, both surgeons and nuclear medicine specialists playing a relevant role, and who must be aware of its prognostic significance.