High management impact of Ga‐68 DOTATATE (GaTate) PET/CT for imaging neuroendocrine and other somatostatin expressing tumours

Hofman, Michael S; Kong, Grace; Neels, Oliver; Eu, Peter; Hong, Emily; Hicks, Rodney J.

doi:10.1111/j.1754-9485.2011.02327.x

Cited by 226 publications

(207 citation statements)

References 21 publications

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“…Indeed, such comparative studies also found more foci identified with 68 Ga-based tracers than with SPECT (27,31,32). These studies on average found 30% (27,32,33) more foci using PET than SPECT. Compared with our study in which we found a higher percentage of additional lesions (50%), it seems we could have a better detection rate.…”

Section: Discussionmentioning

confidence: 85%

“…Still, whether 10 or 15 liver metastases are found is not necessarily important additional information. However, also when analyzing organ by organ, 58 additional organ systems were found to be involved in 40 patients when 64 Cu-DOTATATE was used, compared with 111 In-DTPA-OC, which could potentially be of importance for the prognosis (23,24) and treatment selection (25)(26)(27)(28). Nevertheless, more foci found by PET are not necessarily representative of true-positive foci.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

⁶⁴Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with ¹¹¹In-DTPA-Octreotide in 112 Patients

et al. 2015

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Neuroendocrine tumors (NETs) can be visualized using radiolabeled somatostatin analogs. We have previously shown the clinical potential of 64 Cu-DOTATATE in a small first-in-human feasibility study. The aim of the present study was, in a larger prospective design, to compare on a head-to-head basis the performance of 64 In-diethylenetriaminepentaacetic acid (DTPA)-octreotide ( 111 In-DTPA-OC) as a basis for implementing 64 Cu-DOTATATE as a routine. Methods: We prospectively enrolled 112 patients with pathologically confirmed NETs of gastroenteropancreatic or pulmonary origin. All patients underwent both PET/CT with 64 Cu-DOTATATE and SPECT/CT with 111 In-DTPA-OC within 60 d. PET scans were acquired 1 h after injection of 202 MBq (range, 183-232 MBq) of 64 Cu-DOTATATE after a diagnostic contrast-enhanced CT scan. Patients were followed for 42-60 mo for evaluation of discrepant imaging findings. The McNemar test was used to compare the diagnostic performance. Results: Eightyseven patients were congruently PET-and SPECT-positive. No SPECT-positive cases were PET-negative, whereas 10 false-negative SPECT cases were identified using PET. The diagnostic sensitivity and accuracy of 64 Cu-DOTATATE (97% for both) were significantly better than those of 111 In-DTPA-OC (87% and 88%, respectively, P 5 0.017). In 84 patients (75%), 64 Cu-DOTATATE identified more lesions than 111 In-DTPA-OC and always at least as many. In total, twice as many lesions were detected with 64 Cu-DOTATATE than with 111 In-DTPA-OC. Moreover, in 40 of 112 cases (36%) lesions were detected by 64 Cu-DOTATATE in organs not identified as disease-involved by 111 In-DTPA-OC. Conclusion: With these results, we demonstrate that 64 Cu-DOTATATE is far superior to 111 In-DTPA-OC in diagnostic performance in NET patients. Therefore, we do not hesitate to recommend implementation of 64 Cu-DOTATATE as a replacement for 111 In-DTPA-OC.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

⁶⁴Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with ¹¹¹In-DTPA-Octreotide in 112 Patients

et al. 2015

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“…Well-differentiated PNETs In octreotide scintigraphy and 68 Ga-DOTA-octreotate PET/CT were used to obtain non-invasive SSTR images, which were useful in identifying well-differentiated PNETs. Poorly differentiated PNETs, on the other hand, exhibited high 18 F-FDG activity [17][18][19][20][21]. It was reported that 18 F-FDG uptake of PNETs was useful for predicting tumor aggressiveness.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Volume-Based Metabolic Parameters Measured by 18F-FDG PET/CT of Pancreatic Neuroendocrine Tumors

Kim

Choi

et al. 2014

Nucl Med Mol Imaging

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Purpose To date, the prognostic value of 18 F-FDG PET/CT for patients with pancreatic neuroendocrine tumors (PNETs) has not been well characterized. We investigated the prognostic value of volumetric parameters using 18 F-FDG PET/CT in this patient population. Methods We retrospectively reviewed 20 cases of pathologically proven PNET in patients who had undergone pretherapeutic 18 F-FDG PET/CT. PET parameters including maximum and average standardized uptake values (SUV max , SUV ave ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumor were measured using a threshold SUV to determine the boundaries of the tumors. Univariate and multivariate survival analyses were performed with adjustments for PET parameters and other clinical values.Results The median clinical follow-up was 22.3 (range, 1.2-95.4) months. Cancer-related death occurred in 5 of 20 patients (25 %). Patients had clinical or pathological stages of I in seven patients, II in six patients, III in three patient, and IV in four patients. According to the WHO histological classification of subtypes, 3 patients exhibited well-differentiated PNETs, 13 patients had well-differentiated endocrine carcinomas, and 4 had poorly differentiatedendocrine carcinomas. Univariate analysis showed that tumor size (p=0.028), AJCC stage (p=0.009), T stage (p=0.028), M stage (p=0.029), treatment modality (p=0.045), MTV (p=0.003) and TLG (p=0.027) were significant predictors of overall survival. On multivariate analysis, MTV (HR=10.859, p=0.031) was a significant independent predictor of overall survival along with the AJCC stage (HR=11.556, p=0.027).

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“…Usually, high FDG avidity correlates with poorly differentiated pNETs and increased mortality risk [31,32]. Recently, the use of 68 Ga-labeled somatostatin analogs has been proposed by several authors and shown to be superior to both SRS and conventional cross-sectional imaging [33][34][35][36]. Furthermore, the simultaneous use of PET and CT imaging techniques (PET-CT) has been shown to have a sensitivity ranging from 94 to 100 % [34,37].…”

Section: Tumor Localizationmentioning

confidence: 99%

Pancreatic Neuroendocrine Tumors: an Update

2015

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Pancreatic neuroendocrine tumors (pNETs) are rare and comprise only 1-2 % of all pancreatic neoplastic disease. Although the majority of these tumors are sporadic (90 %), pNETs can arise in the setting of several different hereditary genetic syndromes, most commonly multiple endocrine neoplasia type 1 (MEN1). The presentation of pNETs varies widely, with over 60 % having malignant distant disease at the time of initial diagnosis involving the liver or other distant sites. Functioning pNETs represent approximately 10 % of all pNETs, secrete a variety of peptide hormones, and are responsible for several clinical syndromes caused by profound hormonal derangement. Surgery remains the cornerstone of therapy and the only curative approach. It should be pursued for localized disease and for metastatic lesions amenable to resection. Multimodality therapies, including liver-directed therapies and medical therapy, are gaining increasing favor in the treatment of advanced pNETs. Their utility is multifold and spans from ameliorating symptoms of hormonal excess (functional pNETs) to controlling the local and systemic disease burden (non-functional pNETs). The recent introduction of target molecular therapy has promising results especially for the treatment of progressive well-differentiated G1/G2 tumor. In this review, we summarize the current knowledge and give an update on recent advancements made in the therapeutic strategies for pNETs.

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High management impact of Ga‐68 DOTATATE (GaTate) PET/CT for imaging neuroendocrine and other somatostatin expressing tumours

Cited by 226 publications

References 21 publications

⁶⁴Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with ¹¹¹In-DTPA-Octreotide in 112 Patients

⁶⁴Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with ¹¹¹In-DTPA-Octreotide in 112 Patients

Prognostic Value of Volume-Based Metabolic Parameters Measured by 18F-FDG PET/CT of Pancreatic Neuroendocrine Tumors

Pancreatic Neuroendocrine Tumors: an Update

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High management impact of Ga‐68 DOTATATE (GaTate) PET/CT for imaging neuroendocrine and other somatostatin expressing tumours

Cited by 226 publications

References 21 publications

64Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with 111In-DTPA-Octreotide in 112 Patients

64Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with 111In-DTPA-Octreotide in 112 Patients

Prognostic Value of Volume-Based Metabolic Parameters Measured by 18F-FDG PET/CT of Pancreatic Neuroendocrine Tumors

Pancreatic Neuroendocrine Tumors: an Update

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⁶⁴Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with ¹¹¹In-DTPA-Octreotide in 112 Patients

⁶⁴Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with ¹¹¹In-DTPA-Octreotide in 112 Patients