{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:23:39Z","timestamp":1788863019270,"version":"build-2803163510"},"reference-count":67,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,19]],"date-time":"2021-12-19T00:00:00Z","timestamp":1639872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Neuroendocrine neoplasms (NENs) are rare and heterogeneous epithelial tumors most commonly arising from the gastroenteropancreatic (GEP) system. GEP-NENs account for approximately 60% of all NENs, and the small intestine and pancreas represent two most common sites of primary tumor development. Approximately 80% of metastatic patients have secondary liver lesions, and in approximately 50% of patients, the liver is the only metastatic site. The therapeutic strategy depends on the degree of hepatic metastatic invasion, ranging from liver surgery or percutaneous ablation to palliative treatments to reduce both tumor volume and secretion. In patients with grade 1 and 2 NENs, locoregional nonsurgical treatments of liver metastases mainly include percutaneous ablation and endovascular treatments, targeting few or multiple hepatic metastases, respectively. In the present work, we provide a narrative review of the current knowledge on liver-directed therapy for metastasis treatment, including both interventional radiology procedures and nuclear medicine options in NEN patients, taking into account the patient clinical context and both the strengths and limitations of each modality.<\/jats:p>","DOI":"10.3390\/cancers13246368","type":"journal-article","created":{"date-parts":[[2021,12,19]],"date-time":"2021-12-19T20:41:55Z","timestamp":1639946515000},"page":"6368","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Liver-Directed Therapy for Neuroendocrine Metastases: From Interventional Radiology to Nuclear Medicine Procedures"],"prefix":"10.3390","volume":"13","author":[{"given":"Roberto Luigi","family":"Cazzato","sequence":"first","affiliation":[{"name":"Interventional Radiology, University Hospitals of Strasbourg, Strasbourg University, 67000 Strasbourg, France"},{"name":"Oncology, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrice","family":"Hubel\u00e9","sequence":"additional","affiliation":[{"name":"Nuclear Medicine and Molecular Imaging, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"De Marini","sequence":"additional","affiliation":[{"name":"Interventional Radiology, University Hospitals of Strasbourg, Strasbourg University, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Ouvrard","sequence":"additional","affiliation":[{"name":"Nuclear Medicine and Molecular Imaging, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Salvadori","sequence":"additional","affiliation":[{"name":"Radiophysics, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0046-7973","authenticated-orcid":false,"given":"Pietro","family":"Addeo","sequence":"additional","affiliation":[{"name":"Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University Hospitals of Strasbourg, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Garnon","sequence":"additional","affiliation":[{"name":"Interventional Radiology, University Hospitals of Strasbourg, Strasbourg University, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Emmanuel","family":"Kurtz","sequence":"additional","affiliation":[{"name":"Oncology, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Greget","sequence":"additional","affiliation":[{"name":"Interventional Radiology, University Hospitals of Strasbourg, Strasbourg University, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Mertz","sequence":"additional","affiliation":[{"name":"Radiophysics, University Hospitals of Strasbourg, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Goichot","sequence":"additional","affiliation":[{"name":"Internal Medicine, Diabetes and Metabolic Disorders, University Hospitals of Strasbourg, Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afshin","family":"Gangi","sequence":"additional","affiliation":[{"name":"Interventional Radiology, University Hospitals of Strasbourg, Strasbourg University, 67000 Strasbourg, France"},{"name":"School of Biomedical Engineering and Imaging Science, King\u2019s College London, Strand, London WC2R 2LS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Imperiale","sequence":"additional","affiliation":[{"name":"Nuclear Medicine and Molecular Imaging, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, Strasbourg University, 67200 Strasbourg, France"},{"name":"Molecular Imaging\u2014DRHIM, IPHC, UMR 7178, CNRS\/Unistra, 67037 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3063","DOI":"10.1200\/JCO.2007.15.4377","article-title":"One hundred years after \u201ccarcinoid\u201d: Epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States","volume":"26","author":"Yao","year":"2008","journal-title":"J. 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