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Somatostatin receptor (SST) PET/CT is the gold standard for well-differentiated neuroendocrine tumours (NET) imaging. Higher grades of neuroendocrine neoplasms (NEN) show preferential [18F]FDG (FDG) uptake, and even low-grade NET may de-differentiate over time. FDG PET/CT's prognostic role is widely accepted; however, its impact on clinical decision-making remains controversial and its use varies widely. A questionnaire-based survey on FDG PET/CT use and perceived decision-making utility in NEN was submitted to the ENETS Advisory Board Meeting attendees (November 2022, response rate = 70%). In 3/15 statements, agreement was higher than 75%: (i) FDG was considered useful in NET, irrespective of grade, in case of mis-matched lesions (detectable on diagnostic CT but negative/faintly positive on SST PET/CT), especially if PRRT is contemplated (80%); (ii) in NET G3 if curative surgery is considered (82%); and (iii) in NEC prior to surgery with curative intent (98%). FDG use in NET G3, even in the presence of matched lesions, as a baseline for response assessment was favoured by 74%. Four statements obtained more than 60% consensus: (i) FDG use in NET G3 if locoregional therapy is considered (65%); (ii) in neuroendocrine carcinoma before initiating active therapy as a baseline for response assessment (61%); (iii) biopsy to re-assess tumour grade prior to a change in therapeutic management (68%) upon detection of FDG-positivity on the background of a prior G1-2 NET; (iv) 67% were in favour to reconsider PRRT to treat residual SST-positive lesions after achieving complete remission on FDG of the SST-negative disease component. Multidisciplinary opinion broadly supports the use of FDG PET/CT for characterisation of disease biology and to guide treatment selection across a range of indications, despite the lack of full consensus in many situations. This may reflect existing clinical access due to lack of reimbursement or experience with this investigation, which should be add

This ENETS guidance paper, developed by a multidisciplinary working group, provides up-to-date and practical advice on the diagnosis and management of digestive neuroendocrine carcinoma, based on recent developments and study results. These recommendations aim to pave the road for more standardized care for our patients resulting in improved outcomes. Prognosis is generally poor for digestive NEC, most are advanced at diagnosis and median survival in metastatic disease is 11-12 months. Surgery can be of benefit for localized disease after extensive preoperative imaging. Carboplatin in combination with etoposide is recommended as first-line treatment for metastatic disease. Irinotecan with fluoropyrimidines has the best evidence as second-line treatment. Immunotherapy plays a minor role in biomarker-unselected patients. Molecular profiling if available is encouraged to identify new targets. More prospective clinical trials are highly needed to fulfil the unmet needs in this field, especially on new predictive and prognostic biomarkers and to improve survival of patients with advanced disease.

RST/Radiation, Science and Technology

Il tema di ricerca che ha orientato il lavoro presentato è stato il valore simbolico e pedagogico del cibo e delle pratiche alimentari all’interno dei servizi educativi per la prima infanzia. L’obiettivo della ricerca è stato quello analizzare, attraverso una lente multidisciplinare, il cibo quale fatto antropologico totale (Morin, 2013) dimostrando come le pratiche alimentari orientino la vita degli individui nella costruzione del linguaggio e delle categorie di pensiero (Barthes, 1961; Alves, 1998), nella creazione dei legami sociali e nella determinazione di ruoli di genere e classe all’interno delle società (Lévi-Strauss, 1964; Douglas, 1985; Fischler, 1990), nella custodia della memoria collettiva di una comunità (Montanari, 1984; Sutton, 2001) e nell'influenza del processo di soggettivazione dell’essere umano (Klein, 1936, 1957; Bowbly, 1969, 1972, 1980; Winnicot, 1971). La centralità del lavoro proposto è rappresentato dalla riflessione pedagogica sulle pratiche alimentari all’interno dei servizi educativi che mette in evidenza il legame tra educazione e alimentazione: legame profondo ma poco esplorato dalla teoresi educativa (Birbes, 2012; Flowers & Swan, 2012; Isidori, 2015; Sidoti, 2022) e che intreccia temi importanti per la formazione dell’essere umano. Oggetto-soglia che connette il “dentro”, e il “fuori”, il cibo triangola il rapporto tra soggettività, cultura e ambiente, incarnando i valori di convivialità, di trasferimento di conoscenze, di tutela della biodiversità del territorio, di riorientamento degli stili di vita verso forme di consumo più sostenibili per la salute dell’ambiente e dell’umanità (Naess, 1994; Malavasi, 1998; Mortari, 2020). La ricerca empirica relativa a tale studio ha avuto l’obiettivo di analizzare le pratiche alimentari all’interno di due nidi per l’infanzia, con lo scopo di comprendere come il momento del pasto all’interno dei nidi di infanzia contribuisca a far maturare un processo di percezione di sé, sia a liv, The research topic that underpinned the work presented, was the symbolic and pedagogical value of food and food practices within early childhood educational services. The aim of the research was to analyse, through a multidisciplinary lens, food as a global anthropological fact (Morin, 2013) demonstrating how food practices guide the lives of individuals in the construction of language and categories of thought (Barthes, 1961; Alves, 1998), in the creation of social bonds and the determination of gender and class roles within societies (Lévi-Strauss, 1964; Douglas, 1985; Fischler, 1990), in the preservation of the collective memory of a community (Montanari, 1984; Sutton, 2001) and in the influence of the process of embodiment. The centrality of the proposed work is represented by the pedagogical reflection on food practices within educational services that highlights the link between education and food: a deep link but poorly explored by educational theoresis (Birbes, 2012; Flowers & Swan, 2012; Isidori, 2015; Sidoti, 2022) and that crosses important themes for the formation of the human being. As an object-threshold that connects the 'inside', and the 'outside', food triangulates the relationship between subjectivity, culture and the environment, embodying the values of conviviality, knowledge transfer, protection of territorial biodiversity, and reorientation of lifestyles towards more sustainable forms of consumption for the health of the environment and humanity (Naess, 1994; Malavasi, 1998; Mortari, 2020). The empirical research relating to this study had the objective of analysing feeding practices within two nurseries, with the aim of understanding how mealtime within nurseries contributes to the development of a process of self-perception, both at an individual and social level, in children, reflecting on how intergenerational transmission, through nourishment, influences the caring relationships between adults and children. To this purpose, the constructi

Somatostatin receptor (SST) PET/CT is the gold standard for well-differentiated neuroendocrine tumours (NET) imaging. Higher grades of neuroendocrine neoplasms (NEN) show preferential [18F]FDG (FDG) uptake, and even low-grade NET may de-differentiate over time. FDG PET/CT's prognostic role is widely accepted; however, its impact on clinical decision-making remains controversial and its use varies widely. A questionnaire-based survey on FDG PET/CT use and perceived decision-making utility in NEN was submitted to the ENETS Advisory Board Meeting attendees (November 2022, response rate = 70%). In 3/15 statements, agreement was higher than 75%: (i) FDG was considered useful in NET, irrespective of grade, in case of mis-matched lesions (detectable on diagnostic CT but negative/faintly positive on SST PET/CT), especially if PRRT is contemplated (80%); (ii) in NET G3 if curative surgery is considered (82%); and (iii) in NEC prior to surgery with curative intent (98%). FDG use in NET G3, even in the presence of matched lesions, as a baseline for response assessment was favoured by 74%. Four statements obtained more than 60% consensus: (i) FDG use in NET G3 if locoregional therapy is considered (65%); (ii) in neuroendocrine carcinoma before initiating active therapy as a baseline for response assessment (61%); (iii) biopsy to re-assess tumour grade prior to a change in therapeutic management (68%) upon detection of FDG-positivity on the background of a prior G1-2 NET; (iv) 67% were in favour to reconsider PRRT to treat residual SST-positive lesions after achieving complete remission on FDG of the SST-negative disease component. Multidisciplinary opinion broadly supports the use of FDG PET/CT for characterisation of disease biology and to guide treatment selection across a range of indications, despite the lack of full consensus in many situations. This may reflect existing clinical access due to lack of reimbursement or experience with this investigation, which should be