Peptide receptor radionuclide therapy of neuroendocrine tumors with 90Y-DOTATOC: Is treatment response predictable by pre-therapeutic uptake of 68Ga-DOTATOC?

Öksüz, Mehmet Ö.; Winter, Leopold; Pfannenberg, C.; Reischl, Gerald; Müssig, Karsten; Bares, Roland; Dittmann, Helmut

doi:10.1016/j.diii.2013.07.006

Cited by 93 publications

(59 citation statements)

References 38 publications

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“…Early prediction of treatment response is essential to guide tumor therapy and avoid unnecessary side effects and costs from ineffective treatments. SUV has been proposed as a marker of SSTR density but changes of tumor SUV at 68 Ga-DOTATOC PET/CT during PRRT have not been found to reliably correlate with the patient outcome (24,27,(41)(42)(43). It was previously shown that K i and SUV are not linearly correlated for NETs (especially for higher SUVs .…”

Section: Discussionmentioning

confidence: 99%

Parametric Net Influx Rate Images of ⁶⁸Ga-DOTATOC and ⁶⁸Ga-DOTATATE: Quantitative Accuracy and Improved Image Contrast

et al. 2016

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Ga-DOTATOC and Ga-DOTATATE are radiolabeled somatostatin analogs used for the diagnosis of somatostatin receptor-expressing neuroendocrine tumors (NETs), and SUV measurements are suggested for treatment monitoring. However, changes in net influx rate () may better reflect treatment effects than those of the SUV, and accordingly there is a need to compute parametric images showing at the voxel level. The aim of this study was to evaluate parametric methods for computation of parametric images by comparison to volume of interest (VOI)-based methods and to assess image contrast in terms of tumor-to-liver ratio. Ten patients with metastatic NETs underwent a 45-min dynamic PET examination followed by whole-body PET/CT at 1 h after injection ofGa-DOTATOC and Ga-DOTATATE on consecutive days. Parametric images were computed using a basis function method (BFM) implementation of the 2-tissue-irreversible-compartment model and the Patlak method using a descending aorta image-derived input function, and mean tumor values were determined for 50% isocontour VOIs and compared with values based on nonlinear regression (NLR) of the whole-VOI time-activity curve. A subsample of healthy liver was delineated in the whole-body and images, and tumor-to-liver ratios were calculated to evaluate image contrast. Correlation () and agreement between VOI-based and parametric values were assessed using regression and Bland-Altman analysis. The between NLR-based and parametric image-based (BFM) tumor values was 0.98 (slope, 0.81) and 0.97 (slope, 0.88) for Ga-DOTATOC andGa-DOTATATE, respectively. For Patlak analysis, the between NLR-based and parametric-based (Patlak) tumor was 0.95 (slope, 0.71) and 0.92 (slope, 0.74) for Ga-DOTATOC andGa-DOTATATE, respectively. There was no bias between NLR and parametric-based values. Tumor-to-liver contrast was 1.6 and 2.0 times higher in the parametric BFM images and 2.3 and 3.0 times in the Patlak images than in the whole-body images for Ga-DOTATOC andGa-DOTATATE, respectively. A high and agreement between NLR- and parametric-based values was found, showing that images are quantitatively accurate. In addition, tumor-to-liver contrast was superior in the parametric images compared with whole-body images for bothGa-DOTATOC and Ga DOTATATE.

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Section: Discussionmentioning

confidence: 99%

Parametric Net Influx Rate Images of ⁶⁸Ga-DOTATOC and ⁶⁸Ga-DOTATATE: Quantitative Accuracy and Improved Image Contrast

et al. 2016

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“…Für die Empfehlung zur PRRT wurde daher ein Tumor-Uptake über dem normalen Leberuptake empfohlen. Für die Ga-68 DOTA-TOC-PET/CT wurde gezeigt, dass der Therapieerfolg mit der Höhe des maximalen prätherapeutischen Standardized Uptake Value (SUVmax) korreliert [578].…”

Section: Empfehlung Konsensunclassified

S2k-Leitlinie Neuroendokrine Tumore

Gastroenterologie¹,

Tumoren²,

e.V.³

et al. 2018

Z Gastroenterol

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“…Similar to the current study's data, Gabriel et al (18) did not find any relationship between tumor response and SUVs of Ga-68 DOTATATE PET/CT. However, recently Oksüz et al (19) showed a correlation in SUVs of reference lesions and treatment response with a cutoff value of 17.9. Differing from the current study, a mixed response classification and different time period were used for Ga-68 DOTATOC imaging.…”

Section: Treatment Responsementioning

confidence: 99%

The role of baseline Ga-68 DOTATATE positron emission tomography/computed tomography in the prediction of response to fixed-dose peptide receptor radionuclide therapy with Lu-177 DOTATATE*

et al. 2016

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Background/aim: To describe the role of baseline gallium (Ga)-68 DOTATATE positron emission tomography (PET)/computed tomography (CT) in the prediction of the response to peptide receptor radionuclide therapy (PRRT) using lutetium (Lu)-177 DOTATATE.Materials and methods: Analysis was made of baseline Ga-68 DOTATATE PET/CT images of 29 patients (17 females and 12 males; mean age: 50.7 ± 14.6 years) with metastatic neuroendocrine tumors who received PRRT with Lu-177 DOTATATE. Maximum standardized uptake values (SUVmax) of reference lesions and their ratios to physiological uptake organs were calculated. The relationship between these values and the radiological response was analyzed.Results: Partial response was observed in 8 (28%) patients, stable disease in 18 (62%) patients, and progressive disease in 3 (10%) patients. Mean SUVmax of reference lesions was calculated as 23.8 ± 20.5 (min-max: 5.1-87.3). There was no significant correlation between radiological responses and SUVmax of reference lesions and their ratios to other organs. Conclusion:Baseline Ga-68 DOTATATE PET/CT helps to show somatostatin receptor expression status and disease stage in patients who are candidates for PRRT. However, SUVs do not have a role in the prediction of treatment response.

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Peptide receptor radionuclide therapy of neuroendocrine tumors with 90Y-DOTATOC: Is treatment response predictable by pre-therapeutic uptake of 68Ga-DOTATOC?

Cited by 93 publications

References 38 publications

Parametric Net Influx Rate Images of ⁶⁸Ga-DOTATOC and ⁶⁸Ga-DOTATATE: Quantitative Accuracy and Improved Image Contrast

Parametric Net Influx Rate Images of ⁶⁸Ga-DOTATOC and ⁶⁸Ga-DOTATATE: Quantitative Accuracy and Improved Image Contrast

S2k-Leitlinie Neuroendokrine Tumore

The role of baseline Ga-68 DOTATATE positron emission tomography/computed tomography in the prediction of response to fixed-dose peptide receptor radionuclide therapy with Lu-177 DOTATATE*

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Peptide receptor radionuclide therapy of neuroendocrine tumors with 90Y-DOTATOC: Is treatment response predictable by pre-therapeutic uptake of 68Ga-DOTATOC?

Cited by 93 publications

References 38 publications

Parametric Net Influx Rate Images of 68Ga-DOTATOC and 68Ga-DOTATATE: Quantitative Accuracy and Improved Image Contrast

Parametric Net Influx Rate Images of 68Ga-DOTATOC and 68Ga-DOTATATE: Quantitative Accuracy and Improved Image Contrast

S2k-Leitlinie Neuroendokrine Tumore

The role of baseline Ga-68 DOTATATE positron emission tomography/computed tomography in the prediction of response to fixed-dose peptide receptor radionuclide therapy with Lu-177 DOTATATE*

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Product

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Parametric Net Influx Rate Images of ⁶⁸Ga-DOTATOC and ⁶⁸Ga-DOTATATE: Quantitative Accuracy and Improved Image Contrast

Parametric Net Influx Rate Images of ⁶⁸Ga-DOTATOC and ⁶⁸Ga-DOTATATE: Quantitative Accuracy and Improved Image Contrast