68Ga-DOTATATE PET/CT compared to standard imaging in metastatic neuroendocrine tumors: a more sensitive test to detect liver metastasis?

Jackson, Terence; Darwish, Muhammad; Cho, Edward H.; Nagatomo, Kei; Osman, Houssam; Jeyarajah, D. Rohan

doi:10.1007/s00261-021-02990-4

Cited by 17 publications

(12 citation statements)

References 15 publications

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“…Our results demonstrate that SSR-PET/CT provides very high sensitivity (97.0%) and specificity (97.7%) in the detection of patient-based metastatic hepatic involvement in NET patients compared to the reference imaging modality multiparametric MRI with a high PPV (99.0%) and NPV (93.0%). Small series of NET patients have analyzed lesion-based metastatic hepatic involvement and reported a higher sensitivity of MRI imaging of the liver compared to SSR-PET/CT [ 30 ]. Armbruster et al demonstrated higher diagnostic accuracy of 68Ga-DOTATATE-PET/CT parameters in distinction of NELMs and liver tissue compared to dynamic-contrast-enhanced MRI perfusion parameters; of note, highest accuracy was reached with the combination of both, as information of modalities is complementary [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a small study cohort of 32 NET patients, a lesion-based analysis of liver metastases was performed in 68Ga-DOTATATE PET and compared with CT or MRI. 68Ga-DOTATATE PET appeared to be at least equivalent or even superior to MRI or CT in the detection of NET liver metastases [ 30 ]. However, our data presented possible pitfalls and cases (e.g., small liver lesions, low tumor burden) in which MRI remains the essential diagnostic tool.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic performance of PET/CT in the detection of liver metastases in well-differentiated NETs

et al. 2023

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Background The aim of this retrospective study was to compare the diagnostic accuracy of somatostatin receptor (SSR)-PET/CT to liver MRI as reference standard in the evaluation of hepatic involvement in neuroendocrine tumors (NET). Methods An institutional database was screened for “SSR” imaging studies between 2006 and 2021. 1000 NET Patients (grade 1/2) with 2383 SSR-PET/CT studies and matching liver MRI in an interval of +3 months were identified. Medical reports of SSR-PET/CT and MRI were retrospectively evaluated regarding hepatic involvement and either confirmed by both or observed in MRI but not in SSR-PET/CT (false-negative) or in SSR-PET but not in MRI (false-positive). Results Metastatic hepatic involvement was reported in 1650 (69.2%) of the total 2383 SSR-PET/CT imaging studies, whereas MRI detected hepatic involvement in 1685 (70.7%) cases. There were 51 (2.1%) false-negative and 16 (0.7%) false-positive cases. In case of discrepant reports, MRI and PET/CT were reviewed side by side for consensus reading. SSR-PET/CT demonstrated a sensitivity of 97.0% (95%CI: 96.0%, 97.7%), a specificity of 97.7% (95%CI: 96.3%, 98.7%), a PPV of 99.0% (95%CI: 98.4%, 99.4%) and NPV of 93.0% (95%CI: 91.0, 94.8%) in identifying hepatic involvement. The most frequent reason for false-negative results was the small size of lesions with the majority < 0.6 cm. Conclusion This study confirms the high diagnostic accuracy of SSR-PET/CT in the detection of hepatic involvement in NET patients based on a patient-based analysis of metastatic hepatic involvement with a high sensitivity and specificity using liver MRI imaging as reference standard. However, one should be aware of possible pitfalls when a single imaging method is used in evaluating neuroendocrine liver metastases in patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of PET/CT in the detection of liver metastases in well-differentiated NETs

et al. 2023

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“…NETs are rare tumors arising from the neural crest cells dispersed throughout the body and belong to the amine precursor and decarboxylation group. [1][2][3][4] NETs can be classified into functional or nonfunctional subgroups based on the production of amine/hormone, with most of them showing the expression of several receptors in high quantities. 5 The NETs are associated with overexpression of somatostatin receptor (SSTR) receptors, mainly SSTR 2, 3, and 5.…”

Section: Figurementioning

confidence: 99%

“…In addition, increased tracer uptake is also localized to the gall bladder and bile ducts on axial PET ( H ), CT ( I ), and fused PET/CT ( J ). NETs are rare tumors arising from the neural crest cells dispersed throughout the body and belong to the amine precursor and decarboxylation group 1–4 . NETs can be classified into functional or nonfunctional subgroups based on the production of amine/hormone, with most of them showing the expression of several receptors in high quantities 5 .…”

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confidence: 99%

Exceptional Visualization of the Gallbladder on 68Ga-DOTANOC PET/CT Imaging

2022

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Neuroendocrine tumors (NETs) are rare tumors associated with the overexpression of somatostatin receptors owing to their origin from neural crest cells. The somatostatin receptor-based molecular imaging of NETs with 68 Ga-DOTANOC is extensively used to diagnose primary and metastatic disease with high diagnostic accuracy. Unlike conventional octreotide imaging, physiological gallbladder uptake is not seen on 68 Ga-DOTANOC PET/CT imaging. The present case report exhibits the rare physiological 68 Ga-DOTANOC uptake in the gall bladder and bile duct.

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“…Current guidelines recommend surveillance to identify candidates for the intervention of recurrent disease 5 . Surveillance is conducted primarily with computerized tomography (CT) or magnetic resonance imaging (MRI) 6 while the role of functional imaging with somatostatin receptor scintigraphy (SRS), metaiodobenzylguanidine (MIBG) scan, fluorodeoxyglucose positron emission tomography ( 18 F‐FDG PET/CT), and Gallium (Ga)‐68 Dotatate PET/CT ( 68 Ga‐DOTATATE) scan is undetermined 7–11 . Definitive guidelines for imaging frequency post‐resection and its impact on survival outcomes are not well established.…”

Section: Introductionmentioning

confidence: 99%

Association between surveillance imaging and survival outcomes in small bowel neuroendocrine tumors

Watanabe

McKendry

Yip

et al. 2022

Journal of Surgical Oncology

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Background Surveillance guidelines following the resection of small bowel neuroendocrine tumors (SB‐NETs) are inconsistent. We evaluated the impact of surveillance imaging on SB‐NET recurrence and overall survival (OS). Methods Patients with completely resected SB‐NETs referred to a provincial cancer center (2004–2015) were reviewed. Associations between imaging frequency, recurrence, post‐recurrence treatment, and OS were determined using univariate and Cox‐regression analyses. Results Among 195 completely resected SB‐NET patients, 31% were ≥70 years, 43% were female, and 80% had grade 1 disease. Imaging frequency was predictive of recurrence (hazard ratio 2.52, 95% confidence interval 1.84–3.46, p < 0.001). 72% underwent interventions for recurrent disease. Patients who were treated for the recurrent disease had comparable OS to those who did not recur (median 152 vs. 164 months; p = 0.25). Imaging frequency was not associated with OS in those with treated recurrent disease (p = 0.65). Patients who recurred underwent more computerized tomography (CT) scans than those who did not recur (CT: 1.47 ± 0.89 vs. 1.02 ± 0.81 scans/year, p < 0.001). Detection of disease recurrence was 5%–7% per year during the first 6 years of surveillance and peaked at 17% in Year 9. Conclusion Less frequent imaging over a longer duration should be emphasized to capture clinically relevant recurrences that can be treated to improve OS.

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68Ga-DOTATATE PET/CT compared to standard imaging in metastatic neuroendocrine tumors: a more sensitive test to detect liver metastasis?

Cited by 17 publications

References 15 publications

Diagnostic performance of PET/CT in the detection of liver metastases in well-differentiated NETs

Diagnostic performance of PET/CT in the detection of liver metastases in well-differentiated NETs

Exceptional Visualization of the Gallbladder on 68Ga-DOTANOC PET/CT Imaging

Association between surveillance imaging and survival outcomes in small bowel neuroendocrine tumors

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