Diagnostic Value of 68Ga-DOTATATE PET/CT in Liver Metastases of Neuroendocrine Tumours of Unknown Origin

Tan, Teik Hin; Lee, Boon Nang; Hassan, Siti Zarina Amir

doi:10.1007/s13139-013-0258-9

Cited by 13 publications

(9 citation statements)

References 25 publications

(27 reference statements)

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“…68 Ga-DOTATATE PET/CT has proven to be a pertinent tool in management of NETs, its utility extending right from diagnosis until prognostication of the disease (9)(10)(11)(12). Another important role that 68 Ga-DOTATATE PET/ CT can play is the detection of the primary tumor site in patients of CUP-NETs, an essential step toward patient management (15)(16)(17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

“…68 Ga-DOTATATE PET/CT has proven to be superior to conventional imaging modalities in detecting the primary in patients with CUP-NET (15)(16)(17)(18)(19)(20). All the cases of CUP-NET are usually initially worked up with conventional imaging modalities such as ultrasonography, CT/ceCT, MRI, and EUS where applicable, which are unsuccessful in identifying the site of origin.…”

Section: Discussionmentioning

confidence: 99%

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MIB-1 Index–Stratified Assessment of Dual-Tracer PET/CT with ⁶⁸Ga-DOTATATE and ¹⁸F-FDG and Multimodality Anatomic Imaging in Metastatic Neuroendocrine Tumors of Unknown Primary in a PRRT Workup Setting

Sampathirao

Basu

2017

J. Nucl. Med. Technol.

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Our aim was to comparatively assess dual-tracer PET/CT (Ga-DOTATATE and F-FDG) and multimodality anatomic imaging in studying metastatic neuroendocrine tumors (NETs) of unknown primary (CUP-NETs) scheduled for peptide receptor radionuclide therapy for divergence of tracer uptake on dual-tracer PET/CT, detection of primary, and overall lesion detection vis-a-vis tumor proliferation index (MIB-1/Ki-67). Fifty-one patients with CUP-NETs (25 men, 26 women; age, 22-74 y), histopathologically proven and thoroughly investigated with conventional imaging modalities (ultrasonography, CT/contrast-enhanced CT, MRI, and endoscopic ultrasound, wherever applicable), were retrospectively analyzed. Patients were primarily referred for deciding on feasibility of peptide receptor radionuclide therapy (except 2 patients), and all had undergone Ga-DOTATATE andF-FDG PET/CT as part of pretreatment workup. The sites of metastases included liver, lung/mediastinum, skeleton, abdominal nodes, and other soft-tissue sites. Patients were divided into 5 groups on the basis of MIB-1/Ki-67 index on a 5-point scale: group I (1%-5%) ( = 35), group II (6%-10%) ( = 8), group III (11%-15%) ( = 4), group IV (16%-20%) ( = 2), and group V (>20%) ( = 2). Semiquantitative analysis of tracer uptake was undertaken by SUV of metastatic lesions and the primary (when detected). The SUV values were studied over increasing MIB-1/Ki-67 index. The detection sensitivity of Ga-DOTATATE for primary and metastatic lesions was assessed and compared with other imaging modalities includingF-FDG PET/CT. Unknown primary was detected onGa-DOTATATE in 31 of 51 patients, resulting in sensitivity of 60.78% whereas overall lesion detection sensitivity was 96.87%. The overall lesion detection sensitivities (individual groupwise from group I to group V) were 97.75%, 87.5%, 100%, 100%, and 66.67%, respectively. As MIB-1/Ki-67 index increased, Ga-DOTATATE uptake decreased in metastatic and primary lesions (mean SUV, 43.5 and 22.68 g/dL in group I to 22.54 and 16.83 g/dL in group V, respectively), whereas F-FDG uptake showed a gradual rise (mean SUV, 3.66 and 2.86 g/dL in group I to 7.53 and 9.58 g/dL in group V, respectively). There was a corresponding decrease in the Ga-DOTATATE-to-F-FDG uptake ratio with increasing MIB-1/Ki-67 index (from 11.89 in group I to 2.99 in group V). In CUP-NETs, the pattern of uptake on dual-tracer PET (Ga-DOTATATE and F-FDG) correlates well with tumor proliferation index with a few outliers; combined dual-tracer PET/CT with MIB-1/Ki-67 index would aid in better whole-body assessment of tumor biology in CUP-NETs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

MIB-1 Index–Stratified Assessment of Dual-Tracer PET/CT with ⁶⁸Ga-DOTATATE and ¹⁸F-FDG and Multimodality Anatomic Imaging in Metastatic Neuroendocrine Tumors of Unknown Primary in a PRRT Workup Setting

Sampathirao

Basu

2017

J. Nucl. Med. Technol.

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“…These include immunohistochemistry of transcription factors (CDX-2, Islet-1, TTF-1) [88], PET/CT (e.g. Ga 68-SR, 11 C-5-hydroxytryptophan or 18 F-DOPA) [89,90] and upper and lower gastrointestinal endoscopy and optionally capsule endoscopy [91,92]. If the primary tumor site remains unknown, therapeutic decision making is essentially based on grading, functionality, SSTR status, tumor extent and hepatic tumor burden.…”

Section: Management Of Net With Unknown Primary Tumormentioning

confidence: 99%

ENETS Consensus Guidelines Update for the Management of Distant Metastatic Disease of Intestinal, Pancreatic, Bronchial Neuroendocrine Neoplasms (NEN) and NEN of Unknown Primary Site

et al. 2016

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“…Enteroscopy has low accuracy in detecting NETs of the small intestine (sensitivity of 33%) [ 39 ]. As for functional tests, PET/CT 68 Ga is considered an excellent imaging method for detecting occult primary tumours [ 40 – 43 ]. An observational study showed that PET/CT 68 Ga identified 59% of occult NETs [ 41 ].…”

Section: Diagnosis and Stagingmentioning

confidence: 99%

Guidelines for the management of neuroendocrine tumours by the Brazilian gastrointestinal tumour group

Riechelmann¹,

Weschenfelder

Costa

et al. 2017

ecancer

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Neuroendocrine tumours are a heterogeneous group of diseases with a significant variety of diagnostic tests and treatment modalities. Guidelines were developed by North American and European groups to recommend their best management. However, local particularities and relativisms found worldwide led us to create Brazilian guidelines. Our consensus considered the best feasible strategies in an environment involving more limited resources. We believe that our recommendations may be extended to other countries with similar economic standards.

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Diagnostic Value of 68Ga-DOTATATE PET/CT in Liver Metastases of Neuroendocrine Tumours of Unknown Origin

Abstract: Our small study indicates that (68)Ga-DOTATATE PET/CT is a promising diagnostic option in the multimodality approach to neuroendocrine liver metastases of unknown primary origin.

Cited by 13 publications

References 25 publications

MIB-1 Index–Stratified Assessment of Dual-Tracer PET/CT with ⁶⁸Ga-DOTATATE and ¹⁸F-FDG and Multimodality Anatomic Imaging in Metastatic Neuroendocrine Tumors of Unknown Primary in a PRRT Workup Setting

MIB-1 Index–Stratified Assessment of Dual-Tracer PET/CT with ⁶⁸Ga-DOTATATE and ¹⁸F-FDG and Multimodality Anatomic Imaging in Metastatic Neuroendocrine Tumors of Unknown Primary in a PRRT Workup Setting

ENETS Consensus Guidelines Update for the Management of Distant Metastatic Disease of Intestinal, Pancreatic, Bronchial Neuroendocrine Neoplasms (NEN) and NEN of Unknown Primary Site

Guidelines for the management of neuroendocrine tumours by the Brazilian gastrointestinal tumour group

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Diagnostic Value of 68Ga-DOTATATE PET/CT in Liver Metastases of Neuroendocrine Tumours of Unknown Origin

Abstract: Our small study indicates that (68)Ga-DOTATATE PET/CT is a promising diagnostic option in the multimodality approach to neuroendocrine liver metastases of unknown primary origin.

Cited by 13 publications

References 25 publications

MIB-1 Index–Stratified Assessment of Dual-Tracer PET/CT with 68Ga-DOTATATE and 18F-FDG and Multimodality Anatomic Imaging in Metastatic Neuroendocrine Tumors of Unknown Primary in a PRRT Workup Setting

MIB-1 Index–Stratified Assessment of Dual-Tracer PET/CT with 68Ga-DOTATATE and 18F-FDG and Multimodality Anatomic Imaging in Metastatic Neuroendocrine Tumors of Unknown Primary in a PRRT Workup Setting

ENETS Consensus Guidelines Update for the Management of Distant Metastatic Disease of Intestinal, Pancreatic, Bronchial Neuroendocrine Neoplasms (NEN) and NEN of Unknown Primary Site

Guidelines for the management of neuroendocrine tumours by the Brazilian gastrointestinal tumour group

Contact Info

Product

Resources

About

MIB-1 Index–Stratified Assessment of Dual-Tracer PET/CT with ⁶⁸Ga-DOTATATE and ¹⁸F-FDG and Multimodality Anatomic Imaging in Metastatic Neuroendocrine Tumors of Unknown Primary in a PRRT Workup Setting

MIB-1 Index–Stratified Assessment of Dual-Tracer PET/CT with ⁶⁸Ga-DOTATATE and ¹⁸F-FDG and Multimodality Anatomic Imaging in Metastatic Neuroendocrine Tumors of Unknown Primary in a PRRT Workup Setting