Krenning score of neuroendocrine tumor uptake

Last revised by Daniel J Bell on 1 Sep 2021

Citation, DOI, disclosures and article data

Citation:

Dmytriw A, Bell D, Di Muzio B, et al. Krenning score of neuroendocrine tumor uptake. Reference article, Radiopaedia.org (Accessed on 20 Apr 2024) https://doi.org/10.53347/rID-57295

DOI:

https://doi.org/10.53347/rID-57295

Permalink:

https://radiopaedia.org/articles/57295

rID:

57295

Article created:

17 Dec 2017, Adam A Dmytriw

Disclosures:

At the time the article was created Adam A Dmytriw had no recorded disclosures.

View Adam A Dmytriw's current disclosures

Last revised:

1 Sep 2021, Daniel J Bell ◉

Disclosures:

At the time the article was last revised Daniel J Bell had no recorded disclosures.

View Daniel J Bell's current disclosures

Revisions:

8 times, by 6 contributors - see full revision history and disclosures

Systems:

Gastrointestinal, Hepatobiliary, Oncology

Sections:

Classifications

Tags:

nuclear medicine, octreotide, scintigraphy, spect

Synonyms:

Krenning scores (neuroendocrine tumour uptake)
Krenning score (neuroendocrine tumour uptake)

The Krenning score is a proposed semi-quantitative method of assessing the degree of tracer uptake on octreotide scintigraphy.

Parameters

Initially designed for assessment of ¹¹¹In-DTPA on planar imaging, the Krenning score is applicable to SPECT or PET-CT using various radiopharmaceuticals.

Determination of the Krenning score requires comparison to the liver and spleen (or kidney if not applicable).

Relative uptake score

0: none
1: much lower than liver
2: slightly less than or equal to liver
3: greater than liver
4: greater than spleen

Important points

the commonest contemporary application of the Krenning score is to assess candidacy for peptide receptor radionuclide therapy (PRRT), such as ¹⁷⁷Lu-DOTATATE, usually with a score greater than 2
false-positive localization in general for somatostatin scintigraphy may be as high as 12% and thus scoring and interpretation should take place in the appropriate clinical context (e.g. serum chromogranin A, urine 5-HIAA, and tumor grade)
the scale has shown potential for use in other somatostatin receptor imaging modalities such as ⁶⁸Ga-DOTATATE PET-CT ²

History and etymology

The notion of grading neuroendocrine tumor uptake was introduced by Eric Krenning, a Dutch physician, who led whole-body efforts into somatostatin receptor imaging ¹.