Prognostic Value of Volume-Based Parameters Measured by SSTR PET/CT in Neuroendocrine Tumors: A Systematic Review and Meta-Analysis

Hou, Jing; Yang, Yi; Chen, Na; Chen, Dengming; Hu, Shuo

doi:10.3389/fmed.2021.771912

Cited by 15 publications

(13 citation statements)

References 44 publications

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“…RTV sstr had a better prognostic significance than SUVmax sstr in this setting. Although already described in metastatic and all grades of pancreatic NET, 14 , 17 - 22 the finding is novel since linked to patients with primary GEP-NET complying with loco-regional disease, whose curative intent surgery was shortly performed. Generally, considering the relative quiescence of GEP-NET, it seems appropriate to measure the prognostic potential of different indicators by progression- or event free survival (PFS; EFS) rather than overall survival as partially reported below.…”

Section: Discussionmentioning

confidence: 99%

Ga-68-Edotreotide Positron Emission Tomography/Computed Tomography Somatostatin Receptors Tumor Volume Predicts Outcome in Patients With Primary Gastroenteropancreatic Neuroendocrine Tumors

et al. 2023

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Background We retrospectively aimed to assess the prognostic significance of somatostatin receptor (SSTR) standardized uptake value (SUVmaxsstr), SSTR representative tumor volume (RTVsstr) and total lesion SSTR expression (TLsstr) obtained by [68Ga]Ga-edotreotide PET/CT ([68Ga]Ga-SSTR PET/CT) in patients with primary gastroenteropancreatic neuroendocrine tumors (GEP-NET) before surgery. Material and Methods We analyzed patients who underwent [68Ga]Ga-SSTR PET/CT 3-6 weeks before surgery from February 2020 to April 2022. The mean SUVmaxsstr value, the RTVsstr (cm3; 42% threshold) and the TLsstr (g) were registered. Thereafter the patients were followed up 10.3 months (range 3-27). The PET/CT results were compared to the event free survival (EFS). Results Forty-two patients (61 ± 13 years) have been enrolled. At multivariate analysis only RTVsstr values were predictive. The Kaplan-Meier survival analysis for RTVsstr showed a significant better EFS in patients presenting lower values as compared to those having greater ( P = .003, log-rank test). SUVmaxsstr was not suitable for predicting EFS, TLsstr mildly. Conclusion RTVsstr represents a valuable volumetric parameter able to predict the outcome in GEP-NET patients who underwent surgery. The magnitude of the SSTR representative tumor burden holds a predominant value for determining the response to therapy in GEP-NET patients before surgery, rather than the maximal SSTR representation at single voxel.

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Section: Discussionmentioning

confidence: 99%

Ga-68-Edotreotide Positron Emission Tomography/Computed Tomography Somatostatin Receptors Tumor Volume Predicts Outcome in Patients With Primary Gastroenteropancreatic Neuroendocrine Tumors

et al. 2023

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“…Besides the NETest, which represents a bright opportunity for the future early identification of PRRT nonresponders, some more reliable parameters are needed to identify patients who can most likely benefit from PRRT, as well as for assessing response to therapy [34]. Recently, volumetric parameters extracted from [ 68 Ga]Ga-DOTA-SSTR PET/CT have been utilized in several research papers with promising results in terms of outcome predictions in various settings of disease [32,[35][36][37]. The aim of our work was to assess the relevance of volumetric parameters extracted by [ 68 Ga]Ga-DOTATOC PET/CT to predict early clinical response and long-term outcomes of NET patients treated with PRRT.…”

Section: Discussionmentioning

confidence: 99%

Relevance of Volumetric Parameters Applied to [68Ga]Ga-DOTATOC PET/CT in NET Patients Treated with PRRT

et al. 2023

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Background: this study aims to explore the prognostic and predictive role of volumetric parameters on [68Ga]Ga-DOTATOC PET/CT in neuroendocrine tumors (NET) patients treated with peptide receptor radionuclide therapy (PRRT). Methods: We retrospectively evaluated 39 NET patients (21 male, 18 female; mean age 60.7 y) within the FENET-2016 trial (CTiD:NCT04790708). PRRT was proposed with [177Lu]Lu-DOTATOC alone or combined with [90Y]Y-DOTATOC. [68Ga]Ga-DOTATOC PET/CT was performed at baseline and 3 months after PRRT. For each PET/CT, we calculated SUVmax, SUVmean, somatostatin receptor expressing tumor volume (SRETV), and total lesion somatostatin receptor expression (TLSRE), as well as their percentage of changes (Δ), both for liver (_L) and for total tumor burden (_WB). Early clinical response (3 months after PRRT) and PFS were evaluated according to RECIST 1.1 and institutional NET board. Results: Early clinical response identified 9 partial response (PR), 25 stable disease (SD), and 5 progressive disease (PD). Post-SRETV_WB and ΔSRETV_WB were progressively increased among response groups (p = 0.02 and p = 0.03, respectively). Likewise, median post-SRETV_L was significantly higher in PD patients (p = 0.03). SUVmax and TLSRE did not correlate with early clinical response. Median PFS was 31 months. Patients with ΔSRETV_WB lower than −4.17% as well as those with post-SRETV_WB lower than 34.8 cm3 showed a longer PFS (p = 0.006 and p = 0.06, respectively). Finally, multivariate analysis identified ΔSRETV_WB as an independent predictor for PFS. Conclusions: our results could strengthen the importance of evaluating the burden of disease on [68Ga]Ga-DOTATOC PET/CT in NET patients treated with PRRT.

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“…A meta-analysis conducted by Hou et al (nine studies and 593 patients) reported an association between high RTV and shorter PFS and OS [ 64 ].…”

Section: Updates In Prrtmentioning

confidence: 99%

Radionuclide Theranostics in Neuroendocrine Neoplasms: An Update

Di Franco,

Zanoni,

Fortunati

et al. 2024

Curr Oncol Rep

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Purpose of Review This paper aims to address the latest findings in neuroendocrine tumor (NET) theranostics, focusing on new evidence and future directions of combined diagnosis with positron emission tomography (PET) and treatment with peptide receptor radionuclide therapy (PRRT). Recent Findings Following NETTER-1 trial, PRRT with [177Lu]Lu-DOTATATE was approved by FDA and EMA and is routinely employed in advanced G1 and G2 SST (somatostatin receptor)-expressing NET. Different approaches have been proposed so far to improve the PRRT therapeutic index, encompassing re-treatment protocols, combinations with other therapies and novel indications. Molecular imaging holds a potential added value in characterizing disease biology and heterogeneity using different radiopharmaceuticals (e.g., SST and FDG) and may provide predictive and prognostic parameters. Response assessment criteria are still an unmet need and new theranostic pairs showed preliminary encouraging results. Summary PRRT for NET has become a paradigm of modern theranostics. PRRT holds a favorable toxicity profile, and it is associated with a prolonged time to progression, reduction of symptoms, and improved patients’ quality of life. In light of further optimization, different new strategies have been investigated, along with the development of new radiopharmaceuticals.

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Prognostic Value of Volume-Based Parameters Measured by SSTR PET/CT in Neuroendocrine Tumors: A Systematic Review and Meta-Analysis

Cited by 15 publications

References 44 publications

Ga-68-Edotreotide Positron Emission Tomography/Computed Tomography Somatostatin Receptors Tumor Volume Predicts Outcome in Patients With Primary Gastroenteropancreatic Neuroendocrine Tumors

Ga-68-Edotreotide Positron Emission Tomography/Computed Tomography Somatostatin Receptors Tumor Volume Predicts Outcome in Patients With Primary Gastroenteropancreatic Neuroendocrine Tumors

Relevance of Volumetric Parameters Applied to [68Ga]Ga-DOTATOC PET/CT in NET Patients Treated with PRRT

Radionuclide Theranostics in Neuroendocrine Neoplasms: An Update

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