68Ga-DOTATATE PET/CT compared to standard imaging in metastatic neuroendocrine tumors: a more sensitive test to detect liver metastasis?

AbstractTo present the feasibility of a dynamic whole-body (DWB) 68Ga-DOTATOC-PET/CT acquisition in patients with well-differentiated neuroendocrine tumors (WD-NETs). Sixty-one patients who underwent a DWB 68Ga-DOTATOC-PET/CT for a histologically proven/highly suspected WD-NET were prospectively included. The acquisition consisted in single-bed dynamic acquisition centered on the heart, followed by the DWB and static acquisitions. For liver, spleen and tumor (1–5/patient), Ki values (in ml/min/100 ml) were calculated according to Patlak's analysis and tumor-to-liver (TLR-Ki) and tumor-to-spleen ratios (TSR-Ki) were recorded. Ki-based parameters were compared to static parameters (SUVmax/SUVmean, TLR/TSRmean, according to liver/spleen SUVmean), in the whole-cohort and according to the PET system (analog/digital). A correlation analysis between SUVmean/Ki was performed using linear and non-linear regressions. Ki-liver was not influenced by the PET system used, unlike SUVmax/SUVmean. The regression analysis showed a non-linear relation between Ki/SUVmean (R2 = 0.55,0.68 and 0.71 for liver, spleen and tumor uptake, respectively) and a linear relation between TLRmean/TLR-Ki (R2 = 0.75). These results were not affected by the PET system, on the contrary of the relation between TSRmean/TSR-Ki (R2 = 0.94 and 0.73 using linear and non-linear regressions in digital and analog systems, respectively). Our study is the first showing the feasibility of a DWB 68Ga-DOTATOC-PET/CT acquisition in WD-NETs.

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Management Impact of 68Ga-DOTATATE PET/CT in Neuroendocrine Tumors

Nuclear Medicine and Molecular Imaging ◽

10.1007/s13139-020-00677-0 ◽

2021 ◽

Author(s):

Redmond-Craig Anderson ◽

Erik M. Velez ◽

Bhushan Desai ◽

Hossein Jadvar

Keyword(s):

Neuroendocrine Tumors ◽

Pet Ct

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Impact of PET data driven respiratory motion correction and BSREM reconstruction of 68Ga-DOTATATE PET/CT for differentiating neuroendocrine tumors (NET) and intrapancreatic accessory spleens (IPAS)

Scientific Reports ◽

10.1038/s41598-020-80855-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Virginia Liberini ◽

Fotis Kotasidis ◽

Valerie Treyer ◽

Michael Messerli ◽

Erika Orita ◽

...

Keyword(s):

Neuroendocrine Tumors ◽

Motion Correction ◽

Accessory Spleen ◽

Pancreatic Neuroendocrine Tumor ◽

Reconstruction Algorithm ◽

Data Driven ◽

Operating Characteristics ◽

Quantitative Pet ◽

Pet Ct ◽

Accessory Spleens

AbstractTo evaluate whether quantitative PET parameters of motion-corrected 68Ga-DOTATATE PET/CT can differentiate between intrapancreatic accessory spleens (IPAS) and pancreatic neuroendocrine tumor (pNET). A total of 498 consecutive patients with neuroendocrine tumors (NET) who underwent 68Ga-DOTATATE PET/CT between March 2017 and July 2019 were retrospectively analyzed. Subjects with accessory spleens (n = 43, thereof 7 IPAS) and pNET (n = 9) were included, resulting in a total of 45 scans. PET images were reconstructed using ordered-subsets expectation maximization (OSEM) and a fully convergent iterative image reconstruction algorithm with β-values of 1000 (BSREM1000). A data-driven gating (DDG) technique (MOTIONFREE, GE Healthcare) was applied to extract respiratory triggers and use them for PET motion correction within both reconstructions. PET parameters among different samples were compared using non-parametric tests. Receiver operating characteristics (ROC) analyzed the ability of PET parameters to differentiate IPAS and pNETs. SUVmax was able to distinguish pNET from accessory spleens and IPAs in BSREM1000 reconstructions (p < 0.05). This result was more reliable using DDG-based motion correction (p < 0.003) and was achieved in both OSEM and BSREM1000 reconstructions. For differentiating accessory spleens and pNETs with specificity 100%, the ROC analysis yielded an AUC of 0.742 (sensitivity 56%)/0.765 (sensitivity 56%)/0.846 (sensitivity 62%)/0.840 (sensitivity 63%) for SUVmax 36.7/41.9/36.9/41.7 in OSEM/BSREM1000/OSEM + DDG/BSREM1000 + DDG, respectively. BSREM1000 + DDG can accurately differentiate pNET from accessory spleen. Both BSREM1000 and DDG lead to a significant SUV increase compared to OSEM and non-motion-corrected data.

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Dual-tracer (68Ga-DOTATOC and 18F-FDG-)-PET/CT scan and G1-G2 non-functioning pancreatic neuroendocrine tumors: A single-center retrospective evaluation of 124 non-metastatic resected cases

Neuroendocrinology ◽

10.1159/000514809 ◽

2021 ◽

Author(s):

Salvatore Paiella ◽

Luca Landoni ◽

Sarah Tebaldi ◽

Michele Zuffante ◽

Matteo Salgarello ◽

...

Keyword(s):

Ct Scan ◽

Neuroendocrine Tumors ◽

Fdg Pet ◽

Pancreatic Neuroendocrine Tumors ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Work Up ◽

Pet Ct Scan ◽

Dual Tracer

Introduction:The combined use of 68Gallium [68GA]-DOTA-peptides and 18Fluorine-fluoro-2-deoxyglucose [18F-FDG] PET/TC scans in the work-up of pancreatic neuroendocrine tumors (PanNETs) is controversial. This study aimed at assessing both tracers’ capability to identify tumors and to assess its association with pathological predictors of recurrence. Methods:Prospectively collected, preoperative, dual-tracer PET/CT scan data of G1-G2, non-metastatic, PanNETs that underwent surgery between January 2013 and October 2019 were retrospectively analyzed. Results:The final cohort consisted of 124 cases. There was an approximately equal distribution of males and females(50.8%/49.2%), and G1 and G2 tumors(49.2%/50.8%). The disease was detected in 122(98.4%) and 64(51.6%) cases by 68Ga-DOTATOC and by 18F-FDG PET/CT scans, respectively, with a combined sensitivity of 99.2%. 18F-FDG-positive examinations found G2 tumors more often than G1 (59.4% versus 40.6%;p = 0.036), and 18F-FDG-positive PanNETs were larger than negative ones (median tumor size 32 mm, IQR 21 versus 26 mm, IQR 20;p = 0.019). The median Ki67 for 18F-FDG-positive and -negative examinations was 3(IQR 4) and 2(IQR 4), respectively, (p = 0.029). At least one pathologic predictor of recurrence was present in 74.6% of 18F-FDG-positive cases (versus 56.7%;p = 0.039), whereas this was not found when dichotomizing the PanNETs by their dimensions (≤/> 20 mm). None of the two tracers predicted nodal metastasis. ROC curve analysis showed that 18F-FDG uptake higher than 4.2 had a sensitivity of 49.2%, and specificity of 73.3% for differentiating G1 from G2 (AUC=0.624, p=0.009). Conclusion: The complementary adoption of 68Ga-DOTATOC and 18F-FDG tracers may be valuable in the diagnostic work-up of PanNETs despite not being a game-changer for the management of PanNETs ≤ 20 mm.

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Integrated PET/CT of Pulmonary Neuroendocrine Tumors: Diagnostic and Prognostic Implications

American Journal of Roentgenology ◽

10.2214/ajr.06.0503 ◽

2007 ◽

Vol 188 (5) ◽

pp. 1223-1231 ◽

Cited By ~ 67

Author(s):

Semin Chong ◽

Kyung Soo Lee ◽

Byung-Tae Kim ◽

Joon Young Choi ◽

Chin A Yi ◽

...

Keyword(s):

Neuroendocrine Tumors ◽

Pet Ct ◽

Prognostic Implications

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Variants and Pitfalls of PET/CT in Neuroendocrine Tumors

Seminars in Nuclear Medicine ◽

10.1053/j.semnuclmed.2021.03.001 ◽

2021 ◽

Author(s):

Alessio Imperiale ◽

Leah Meuter ◽

Karel Pacak ◽

David Taïeb

Keyword(s):

Neuroendocrine Tumors ◽

Pet Ct

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Pathology-Confirmed Granuloma Mimicking Liver Metastasis of Breast Cancer

The International Journal of Biological Markers ◽

10.5301/jbm.5000074 ◽

2014 ◽

Vol 29 (1) ◽

pp. e93-e97

Author(s):

Ting Li ◽

Minhao Fan ◽

Ruohong Shui ◽

Silong Hu ◽

Yunyan Zhang ◽

...

Keyword(s):

Breast Cancer ◽

Liver Metastasis ◽

Liver Lesion ◽

Subsequent Treatment ◽

Position Emission Tomography ◽

Surgical Biopsy ◽

Solitary Lesion ◽

Tissue Samples ◽

Cancer History ◽

Pet Ct

For patients with breast cancer, obtaining tissue samples from liver lesion becomes more and more important for both differential diagnosis and subsequent treatment. However, the procedure is not considered as mandatory routine and is not frequently performed. We here reported about a patient with breast cancer history and a solitary liver metastasis that was clinically diagnosed by both magnetic resonance imaging (MRI) and position emission tomography - computed tomography (PET-CT). However, pathologic diagnosis after partial hepatectomy (between sections VII and VIII) revealed multifocal granulomas. The case further addresses the importance of core needle biopsy, or surgical biopsy, for obtainment of a histological diagnosis, especially in the presence of a solitary lesion, even when the lesion has a typical medical imaging supporting metastasis, and uptake of radioactive 18F-fluorodeoxyglucose (18F-FDG) by PET-CT.

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Effect of Peptide Receptor Radionuclide Therapy on Somatostatin Receptor Status and Glucose Metabolism in Neuroendocrine Tumors: Intraindividual Comparison of Ga-68 DOTANOC PET/CT and F-18 FDG PET/CT

International Journal of Molecular Imaging ◽

10.1155/2011/524130 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 18

Author(s):

Sowon Oh ◽

Vikas Prasad ◽

Dong Soo Lee ◽

R. P. Baum

Keyword(s):

Glucose Metabolism ◽

Neuroendocrine Tumors ◽

Fdg Pet ◽

Radionuclide Therapy ◽

Somatostatin Receptor ◽

Peptide Receptor Radionuclide Therapy ◽

Receptor Expression ◽

Peptide Receptor ◽

Pet Ct ◽

Fdg Pet Ct

The heterogeneous nature of the neuroendocrine tumors (NET) makes it challenging to find one uniformly applicable management protocol which is especially true for diagnosis. The discovery of the overexpression of somatostatin receptors (SMS-R) on neuroendocrine tumor cells lead to the generalized and rapid acceptance of radiolabeled somatostatin receptor analogs for staging and restaging of NET as well as for Peptide Receptor Radionuclide Therapy (PRRNT) using Y-90 and Lu-177 DOTATATE/DOTATOC. In this present work we tried to look in to the effect of PRRNT on the glucose metabolism assessed by F-18 FDG PET/CT and SMS-R density assessed by Ga-68 DOTANOC PET/CT. We observed a complex relationship between the somatostatin receptor expression and glucose metabolism with only 56% (77/138) of the lesions showing match, while the others show mismatch between the receptor status and metabolism. The match between receptor expression and glucose metabolism increases with the grade of NET. In grade 3 NET, there is a concurrence between the changes in glucose metabolism and somatostatin receptor expression. PRRNT was found to be more effective in lesions with higher receptor expression.

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