Is 68Ga-DOTA-NOC PET/CT indicated in patients with clinical, biochemical or radiological suspicion of neuroendocrine tumour?

Ambrosini, Valentina; Campana, Davide; Nanni, Cristina; Cambioli, Silvia; Tomassetti, Paola; Rubello, Domenico; Fanti, Stefano

doi:10.1007/s00259-012-2146-4

Cited by 33 publications

(18 citation statements)

References 36 publications

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“…For primary NENs its sensitivity is estimated at 78-93% and is highest for pancreatic NENs (86-100%) except insulinomas in which case the sensitivity is in general lower starting from 25% in case of 68 Ga-DOTANOC [20] up to 87% in case of DOTATOC [21]. Similar effectiveness for 68 Ga-DOTA-peptides was established in PET/CT in patients with clinical/biochemical/radiological suspicion of NENs [22].…”

Section: Clinical Utility Of Sstr Imagingmentioning

confidence: 69%

NEN — the role of somatostatin receptor scintigraphy in clinical setting

Opalińska

Hubalewska‐Dydejczyk²,

Sowa‐Staszczak

et al. 2016

Nucl. Med. Rev.

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Detection of neuroendocrine neoplasms (NENs) and monitoring of their response to therapy is still challenging due to huge heterogeneity of that group of tumors. Actually, NENs visualization is mainly based on molecular imaging while in the past it was relied on less effective structural imaging including CT and MRI. Molecular imaging techniques in combination with structural imaging (hybrid imaging), especially in patients with well-differentiated NENs, in addition to morphological provide the functional information about tumor which benefits in a more accurate patient management, including more sensitive visualization of primary tumors, more precise staging and better therapy follow-up.Overexpression of somatostatin receptors (SSTR) on NENs' cell membrane was a basis for development of somatostatin receptor scintigraphy (SRS) using single photon emission tomography SPECT, which is today a well-established standard in molecular imaging of NENs, and further imaging improvement in the field of positron emission tomography (PET). Use of hybrid imaging (SPECT/CT, PET/CT) increased sensitivity of examination, mainly resulting in better detection of small lesions.

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Section: Clinical Utility Of Sstr Imagingmentioning

confidence: 69%

NEN — the role of somatostatin receptor scintigraphy in clinical setting

Opalińska

Hubalewska‐Dydejczyk²,

Sowa‐Staszczak

et al. 2016

Nucl. Med. Rev.

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“…In patients in whom clinical, biochemical, or radiologic findings raise the suspicion of an NET, 68 Ga-DOTA-peptide PET should be used with caution. According to a recent study, 68 Ga-DOTA-NOC PET gave true positives in approximately 13% of cases with suspicious lesions in conventional imaging, in 10% of cases with relevant symptoms/signs, and in only 1.5% of cases for whom an NET was suspected based on abnormal biomarkers [42]. …”

Section: Recommendations For Specific Clinical Scenariosmentioning

confidence: 99%

Combination of Cross-Sectional and Molecular Imaging Studies in the Localization of Gastroenteropancreatic Neuroendocrine Tumors

et al. 2014

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Molecular imaging modalities exploit aspects of neuroendocrine tumors (NET) pathophysiology for both diagnostic imaging and therapeutic purposes. The characteristic metabolic pathways of NET determine which tracers are useful for their visualization. In this review, we summarize the diagnostic value of all available molecular imaging studies, present data about their use in daily practice in NET centers globally, and finally make recommendations about the appropriate use of those modalities in specific clinical scenarios. Somatostatin receptor scintigraphy (SRS) continues to have a central role in the diagnostic workup of patients with NET, as it is also widely available. However, and despite the lack of prospective randomized studies, many NET experts predict that Gallium-68 (⁶⁸Ga)-DOTA positron emission tomography (PET) techniques may replace SRS in the future, not only because of their technical advantages, but also because they are superior in patients with small-volume disease, in patients with skeletal metastases, and in those with occult primary tumors. Carbon-11 (¹¹C)-5-hydroxy-L-tryptophan (5-HTP) PET and ¹⁸F-dihydroxyphenylalanine (¹⁸F-DOPA) PET are new molecular imaging techniques of limited availability, and based on retrospective data, their sensitivities seem to be inferior to that of ⁶⁸Ga-DOTA PET. Glucagon-like-peptide-1 (GLP-1) receptor imaging seems promising for localization of the primary in benign insulinomas, but is currently available only in a few centers. Fluorine-18 (¹⁸F)-fluorodeoxyglucose (¹⁸F-FDG) PET was initially thought to be of limited value in NET, due to their usually slow-growing nature. However, according to subsequent data, ¹⁸F-FDG PET is particularly helpful for visualizing the more aggressive NET, such as poorly differentiated neuroendocrine carcinomas, and well-differentiated tumors with Ki67 values >10%. According to limited data, ¹⁸F-FDG-avid tumor lesions, even in slow-growing NET, may indicate a more aggressive disease course. When a secondary malignancy has already been established or is strongly suspected, combining molecular imaging techniques (e.g. ¹⁸F-FDG PET and ⁶⁸Ga-DOTA PET) takes advantage of the diverse avidities of different tumor types to differentiate lesions of different origins. All the above-mentioned molecular imaging studies should always be reviewed and interpreted in a multidisciplinary (tumor board) meeting in combination with the conventional cross-sectional imaging, as the latter remains the imaging of choice for the evaluation of treatment response and disease follow-up.

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“…68 Ga-DOTATATE has a high affinity for sst 2(a) , 68 Ga-DOTATOC has a high affinity for sst 2(a) and sst 5 and 68 Ga-DOTANOC is sst 2(a) , sst 3 and sst 5 specific (13,31,32,33,34). Somatostatin receptor PET/CT using 68 Ga-DO-TANOC, 68 Ga-DOTATATE or 68 Ga-DOTATOC is superior to SRS SPECT-CT showing higher sensitivities for GEP-NET lesion detection (more than 90%), particularly due to a better special resolution or better sst affinities (13,31,32,33,34). These compounds are also more 'patient friendly', as they allow for imaging 1-3 h within i.v.…”

mentioning

confidence: 99%

“…Three different 68 Ga-DOTA-labelled SSAs are used in clinical practice: DOTANOC, DOTATATE and DOTATOC (13,31,32,33,34). These compounds differ with regard to their individual affinity for the different ssts.…”

mentioning

confidence: 99%

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GEP-NETs update: Functional localisation and scintigraphy in neuroendocrine tumours of the gastrointestinal tract and pancreas (GEP-NETs)

Herder¹

2014

European Journal of Endocrinology

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For patients with neuroendocrine tumours (NETs) of the gastrointestinal tract and pancreas (GEP) (GEP-NETs), excellent care should ideally be provided by a multidisciplinary team of skilled health care professionals. In these patients, a combination of nuclear medicine imaging and conventional radiological imaging techniques is usually mandatory for primary tumour visualisation, tumour staging and evaluation of treatment. In specific cases, as in patients with occult insulinomas, sampling procedures can provide a clue as to where to localise the insulin-hypersecreting pancreatic NETs. Recent developments in these fields have led to an increase in the detection rate of primary GEP-NETs and their metastatic deposits. Radiopharmaceuticals targeted at specific tumour cell properties and processes can be used to provide sensitive and specific whole-body imaging. Functional imaging also allows for patient selection for receptor-based therapies and prediction of the efficacy of such therapies. Positron emission tomography/computed tomography (CT) and single-photon emission CT/CT are used to map functional images with anatomical localisations. As a result, tumour imaging and tumour follow-up strategies can be optimised for every individual GEP-NET patient. In some cases, functional imaging might give indications with regard to future tumour behaviour and prognosis.

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Is 68Ga-DOTA-NOC PET/CT indicated in patients with clinical, biochemical or radiological suspicion of neuroendocrine tumour?

Cited by 33 publications

References 36 publications

NEN — the role of somatostatin receptor scintigraphy in clinical setting

NEN — the role of somatostatin receptor scintigraphy in clinical setting

Combination of Cross-Sectional and Molecular Imaging Studies in the Localization of Gastroenteropancreatic Neuroendocrine Tumors

GEP-NETs update: Functional localisation and scintigraphy in neuroendocrine tumours of the gastrointestinal tract and pancreas (GEP-NETs)

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