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Prospective Study of 68 Ga-DOTATATE Positron Emission Tomography/Computed Tomography for Detecting Gastro-Entero-Pancreatic Neuroendocrine Tumors and Unknown Primary Sites
Open accessAbstract
Purpose: Gastro-entero-pancreatic neuroendocrine tumors (GEPNETs) are increasing in incidence, and accurate staging is important for selecting the appropriate treatment. 68 Ga-DOTATATE imaging is a promising approach for detecting GEPNETs and could help in selecting optimal therapeutic strategies. The aim of this study was to prospectively determine the clinical utility of 68 Ga-DOTATATE positron emission tomography (PET)/computed tomography (CT) in detecting unknown primary and metastatic GEPNETs. Patients and Methods: One hundred thirty-one patients were enrolled in a prospective study of patients undergoing 68 Ga-DOTATATE PET/CT, 111 In-pentetreotide single-photon emission computed tomography (SPECT)/CT and multiphasic CT scan, and/or magnetic resonance imaging in a blinded fashion with comprehensive biochemical testing. The primary outcome measure was the detection of lesions by each imaging study. Results: 68 Ga-DOTATATE PET/CT imaging detected 95.1% of lesions (95% CI, 92.4% to 96.8%) with an average maximum standardized uptake value of 65.4 ± 47 (range, 6.9 to 244), anatomic imaging detected 45.3% of lesions (95% CI, 37.9% to 52.9%), and 111 In-pentetreotide SPECT/CT detected 30.9% of lesions (95% CI, 25.0% to 37.5%), with a significant difference between imaging modalities (P < .001). In four of 14 patients (28.6%), 68 Ga-DOTATATE PET/CT found a previously unknown primary tumor, and detected primary GEPNET, lymph node, and distant metastases correctly in 72 of 113 lesions (63.7%) when compared with histopathology, with 22.1% and 38.9% detected by using 111 In-pentetreotide SPECT/CT and anatomic imaging, respectively. On the basis of findings with 68 Ga-DOTATATE PET/CT, 43 of 131 patients (32.8%) had a change in management recommendation. In patients with carcinoid symptoms but negative biochemical testing, 68 Ga-DOTATATE PET/CT detected lesions in 65.2% of patients, 40% of which were detected neither by anatomic imaging nor by 111 In-pentetreotide SPECT/CT. Conclusion: 68 Ga-DOTATATE PET/CT imaging provides important information for accurate staging of GEPNETs and selection of appropriate treatment interventions even in the absence of biochemical evidence of disease in symptomatic patients.
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Gastroenteropancreatic Neuroendocrine Tumors
Cives, M., & Strosberg, J. R. (2018) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21493 · Cited by 586
Howe, J. R., Merchant, N. B., Conrad, C., Keutgen, X. M., Hallet, J., Drebin, J. A., Minter, R. M., Lairmore, T. C., Tseng, J. F., Zeh, H. J., et al. (2020) · Pancreas · doi:10.1097/mpa.0000000000001454 · Cited by 396
Appropriate Use Criteria for Somatostatin Receptor PET Imaging in Neuroendocrine Tumors
Hope, T. A., Bergsland, E. K., Bozkurt, M. F., Graham, M., Heaney, A. P., Herrmann, K., Howe, J. R., Kulke, M. H., Kunz, P. L., Mailman, J., et al. (2018) · Journal of Nuclear Medicine · doi:10.2967/jnumed.117.202275 · Cited by 363
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Innovative imaging of insulinoma: the end of sampling? A review
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Metadata
- Authors
- Sadowski, S. M., Neychev, V., Millo, C., Shih, J., Nilubol, N., Herscovitch, P., Pacak, K., Marx, S. J., & Kebebew, E.
- Venue
- Journal of Clinical Oncology
- Published
- 2016-02-20
- Volume
- 34
- Issue
- 6
- Pages
- 588-596
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2211232874
- Cited by
- 353
- References
- 30
- FWCI
- 18.81
- Type
- journal article
- Language
- en
- Open access
- green
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- Sadowski, S. M., Neychev, V., Millo, C., Shih, J., Nilubol, N., Herscovitch, P., Pacak, K., Marx, S. J., & Kebebew, E. (2016). Prospective Study of 68 Ga-DOTATATE Positron Emission Tomography/Computed Tomography for Detecting Gastro-Entero-Pancreatic Neuroendocrine Tumors and Unknown Primary Sites. Journal of Clinical Oncology. https://doi.org/10.1200/jco.2015.64.0987
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