68Ga PET Imaging in Patients With Neuroendocrine Tumors

Abstract

Purpose The aim of this study was to systematically review the literature to assess the role of 68Ga PET imaging in neuroendocrine tumors (NETs). Materials and Methods The literature was searched using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews databases through OVID. Studies comparing PET or PET/CT with conventional imaging in the initial diagnosis, staging and restaging, assessment of treatment response, and routine surveillance of NETs were deemed eligible for inclusion. Risk of bias and applicability concerns were assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Results Twenty-two studies met the inclusion criteria. For the initial diagnosis of NETs, PET or PET/CT had a pooled sensitivity of 91% (95% confidence interval [CI], 85%–94%) and a pooled specificity of 94% (95% CI, 86%–98%). In the setting of staging and restaging, the sensitivity of PET or PET/CT for detecting primary and/or metastatic lesions ranged from 78.3% to 100%, whereas specificity ranged from 83% to 100%. Change in management occurred in 45% (95% CI, 36%–55%) of the cases, with majority of the changes involving surgical planning and patient selection for peptide receptor radionuclide therapy. Conclusions 68Ga PET or PET/CT is recommended for initial diagnosis where conventional testing remained equivocal, for staging of patients with localized primary and/or limited metastasis where definitive surgery is planned, to determine somatostatin receptor status and suitability for peptide receptor radionuclide therapy, and for staging of patients where detection of occult disease will alter treatment options and decision making.

Asphericity of Somatostatin Receptor Expression in Neuroendocrine Tumors: An Innovative Predictor of Outcome in Everolimus Treatment?

“…Consequently, only two patients with prior SIRT were included, and we believe that this small number does not have a substantial impact on the main results. Mainly due to the remarkable progress and the rising clinical impact of SSR imaging [27], the concept of the ASP will be even transferred to functional PET imaging when enrolling prospective studies. Such prospective studies are required to validate the current explorative results and to ensure a well-selected, homogenous patient collective.…”

Multidisciplinary Management of Neuroendocrine Neoplasia: A Real-World Experience from a Referral Center

“…To date, SRI is considered the most effective diagnostic tool in NENs. Performing SRI may result in a change in clinical management in up to 45% of NEN patients [32], particularly due to the high ability of this technique to detect distant extra-hepatic metastases [33], whose presence is known to be a strong negative prognostic factor affecting patients’ clinical outcome [34]. Changes in clinical management after multidisciplinary discussion consisted of surgical treatment in a relatively low proportion of patients (9%), although 35.4% of include patients have limited disease (Stage I–II).…”

Time course and local distribution of skin exposure of hand and fingers from [68Ga]Ga-DOTA-NOC synthesis using a self-shielded module

“…PET/CT using Gallium-68 ( 68 Ga) labelled radiotracers (e. g. targeting the somatostatin receptor or the prostate specific membranous antigen) are increasingly utilized for molecular imaging [9,20,24]. 68 Ga is usually produced using a Germanium-68 ( 68 Ge)/ 68 Ga-Generator.…”