68Ga-DOTATATE PET/CT in the evaluation of patients with neuroendocrine metastatic carcinoma of unknown origin

Alonso, Ómar; Rodríguez-Taroco, Mónica; Savio, Eduardo; Bentancourt, Cecilia; Gambini, Juan; Engler, Henry

doi:10.1007/s12149-014-0856-3

Cited by 31 publications

(15 citation statements)

References 22 publications

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“…The detection rate of 46% for the unknown primary site with 68 Ga DOTATOC was similar to our findings and significantly better than 8% obtained with 111 In-octreotide. With 68 Ga-DOTATATE PET/CT, Alonso et al reported a detection rate of 59% of primary tumor in 29 patients with metastatic NETs, with a change in management in 24% of patients (20). Findings of our study along with these studies clearly demonstrate the value of PET/CT with 68 Ga-DOTA-octreotide analogs in patients with unknown primary NETs and suggest that for this indication 68 Ga-labeled DOTATOC, DOTANOC, and DOTATATE may be equivalent.…”

Section: Discussionsupporting

confidence: 64%

Localization of Unknown Primary Site with ⁶⁸Ga-DOTATOC PET/CT in Patients with Metastatic Neuroendocrine Tumor

et al. 2017

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Localization of the site of the unknown primary tumor is critical for surgical treatment of patients presenting with neuroendocrine tumor (NET) with metastases. Methods: Forty patients with metastatic NET and unknown primary site underwent 68 Ga-DOTATOC PET/ CT in a single-site prospective study. The 68 Ga-DOTATOC PET/ CT was considered true-positive if the positive primary site was confirmed by histology or follow-up imaging. The scan was considered false-positive if no primary lesion was found corresponding to the 68 Ga-DOTATOC-positive site. All negative scans for primary tumor were considered false-negative. A scan was classified unconfirmed if 68 Ga-DOTATOC PET/CT suggested a primary, however, no histology was obtained and imaging follow-up was not confirmatory. Results: The true-positive, false-positive, falsenegative, and unconfirmed rates for unknown primary tumor were 38%, 7%, 50%, and 5%, respectively. Conclusion: 68 Ga-DOTATOC PET/CT is an effective modality in the localization of unknown primary in patients with metastatic NET.

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Section: Discussionsupporting

confidence: 64%

Localization of Unknown Primary Site with ⁶⁸Ga-DOTATOC PET/CT in Patients with Metastatic Neuroendocrine Tumor

et al. 2017

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“…These 17 studies included 971 participants (median, 44; Inter-quartile range, 22, 51; average age, 56 y [95% CI, 56– 66], with 3 reporting direct comparison of 68 Ga-DOTATATE with octreotide and conventional imaging (14-16), 9 studies comparing 68 Ga-DOTATATE with conventional imaging (17-25), and 5 studies reporting comparison of 68 Ga-DOTATATE with other radiopharmaceuticals without other direct imaging comparator but which were retained for reporting safety, toxicity, and method of 68 Ga-DOTATATE synthesis and administration (26-30). Of the 17 included studies, 8 (47%) were retrospective (14,17,19,21,22,26-28), 8 were prospective (15,17,18,23,25,29-31), and 1 (20) did not report the data collection method. Eight studies (47%) did not blind interpreters, 4 performed some level of blinding, and the remaining 5 did not report their blinding methods.…”

Section: Resultsmentioning

confidence: 99%

⁶⁸Ga-DOTATATE Compared with ¹¹¹In-DTPA-Octreotide and Conventional Imaging for Pulmonary and Gastroenteropancreatic Neuroendocrine Tumors: A Systematic Review and Meta-Analysis

et al. 2016

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Neuroendocrine tumors (NETs) are uncommon tumors with increasing incidence and prevalence. Current reports suggest that 68Ga-DOTATATE PET/CT imaging improves diagnosis and staging of NETs compared with 111In-DTPA-octreotide and conventional imaging. We performed a systematic review of 68Ga-DOTATATE for safety and efficacy compared with octreotide and conventional imaging to determine whether available evidence supports U.S. Food and Drug Administration approval. Methods Medline, EMBASE, Web of Science, and Cochrane Reviews electronic databases were searched from January 1999 to September 2015. Results were restricted to human studies comparing diagnostic accuracy of 68Ga-DOTATATE with octreotide or conventional imaging for pulmonary or gastroenteropancreatic NET and for human studies reporting safety/ toxicity for 68Ga-DOTATATE with 10 subjects or more thought to have NETs. Direct communication with corresponding authors was attempted to obtain missing information. Abstracts meeting eligibility criteria were collected by a research librarian and assembled for reviewers; 2 reviewers independently determined whether or not to include each abstract. If either reviewer chose inclusion, the abstract was accepted for review. Results Database and bibliography searches yielded 2,479 articles, of which 42 were eligible. Three studies compared the 2 radiopharmaceuticals in the same patient, finding 68Ga-DOTATATE to be more sensitive than octreotide. Nine studies compared 68Ga-DOTATATE with conventional imaging. 68Ga-DOTATATE estimated sensitivity, 90.9% (95% confidence interval, 81.4%–96.4%), and specificity, 90.6% (95% confidence interval, 77.8%–96.1%), were high. Five studies were retained for safety reporting only. Report of harm possibly related to 68Ga-DOTATATE was rare (6 of 974), and no study reported major toxicity or safety issues. Conclusion No direct comparison of octreotide and 68Ga-DOTATATE imaging for diagnosis and staging in an unbiased population of NETs has been published. Available information in the peer-reviewed literature regarding diagnostic efficacy and safety supports the use of 68Ga-DOTATATE for imaging of NETs where it is available.

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“…8, 9 PET with 68 Gallium-labeled somatostatin ligands has been used as a tool in localizing unknown primary tumors in metastatic NETs. 10, 11 The use of PET/CT with 68 Ga-DOTATATE, 68 Ga-DOTATOC, or 68 Ga-DOTANOC has been demonstrated as a clinically effective technique for the evaluation of patients with NETs. These tracers have high affinity for SSTR 2, but can also bind with varying affinity to the other SSTR subtypes.…”

Section: Discussionmentioning

confidence: 99%

Results of 68Gallium-DOTATATE PET/CT Scanning in Patients with Multiple Endocrine Neoplasia Type 1

Sadowski

Millo

Cottle‐Delisle

et al. 2015

Journal of the American College of Surgeons

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Background Screening for neuroendocrine tumors (NETs) in patients with multiple endocrine neoplasia type 1 (MEN1) is recommended to detect primary and metastatic tumors, which can result in significant morbidity and mortality. The utility of somatostatin receptor imaging 68Gallium-DOTATATE PET/CT in patients with MEN1 is not known. The aim of this study was to prospectively determine the accuracy of 68Gallium-DOTATATE PET/CT versus 111In-pentetreotide SPECT/CT and anatomic imaging in patients with MEN1. Study design Prospective study comparing 68Gallium-DOTATATE PET/CT, 111In-pentetreotide SPECT/CT, and triphasic CT scan to clinical, biochemical and pathological data in 26 patients with MEN1. Results 68Gallium-DOTATATE PET/CT detected 107 lesions; 111In- pentetreotide SPECT/CT detected 33 lesions; and CT scan detected 48 lesions. Lesions detected on 68Gallium-DOTATATE PET/CT had high SUVmax (median SUVmax = 72.8 [range 19–191]). In 7 of the 26 patients (27%), 68Gallium-DOTATATE PET/CT was positive with a negative 111In-pentetreotide SPECT/CT, and in 10 patients (38.5%), additional metastases were detected (range 0.3 cm to 1.5 cm). In 8 of the 26 patients (31%), there was a change in management recommendations as a result of the findings on 68Gallium-DOTATATE PET/CT that were not seen on 111In- pentetreotide SPECT/CT and CT scan. Conclusions 68Gallium-DOTATATE PET/CT is more sensitive for detecting NETs than 111In-pentetreotide SPECT/CT and CT scan in patients with MEN1. This imaging technique should be integrated into radiologic screening and surveillance of patients with MEN1, as it can significantly alter management recommendations.

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68Ga-DOTATATE PET/CT in the evaluation of patients with neuroendocrine metastatic carcinoma of unknown origin

Abstract: (68)Ga-DOTATATE PET/CT is a clinically useful imaging technique for the localization of primary tumors in patients with neuroendocrine metastatic carcinoma of unknown origin with the potential of having a significant impact in patient management and therapy planning.

Cited by 31 publications

References 22 publications

Localization of Unknown Primary Site with ⁶⁸Ga-DOTATOC PET/CT in Patients with Metastatic Neuroendocrine Tumor

Localization of Unknown Primary Site with ⁶⁸Ga-DOTATOC PET/CT in Patients with Metastatic Neuroendocrine Tumor

⁶⁸Ga-DOTATATE Compared with ¹¹¹In-DTPA-Octreotide and Conventional Imaging for Pulmonary and Gastroenteropancreatic Neuroendocrine Tumors: A Systematic Review and Meta-Analysis

Results of 68Gallium-DOTATATE PET/CT Scanning in Patients with Multiple Endocrine Neoplasia Type 1

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68Ga-DOTATATE PET/CT in the evaluation of patients with neuroendocrine metastatic carcinoma of unknown origin

Abstract: (68)Ga-DOTATATE PET/CT is a clinically useful imaging technique for the localization of primary tumors in patients with neuroendocrine metastatic carcinoma of unknown origin with the potential of having a significant impact in patient management and therapy planning.

Cited by 31 publications

References 22 publications

Localization of Unknown Primary Site with 68Ga-DOTATOC PET/CT in Patients with Metastatic Neuroendocrine Tumor

Localization of Unknown Primary Site with 68Ga-DOTATOC PET/CT in Patients with Metastatic Neuroendocrine Tumor

68Ga-DOTATATE Compared with 111In-DTPA-Octreotide and Conventional Imaging for Pulmonary and Gastroenteropancreatic Neuroendocrine Tumors: A Systematic Review and Meta-Analysis

Results of 68Gallium-DOTATATE PET/CT Scanning in Patients with Multiple Endocrine Neoplasia Type 1

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Localization of Unknown Primary Site with ⁶⁸Ga-DOTATOC PET/CT in Patients with Metastatic Neuroendocrine Tumor

Localization of Unknown Primary Site with ⁶⁸Ga-DOTATOC PET/CT in Patients with Metastatic Neuroendocrine Tumor

⁶⁸Ga-DOTATATE Compared with ¹¹¹In-DTPA-Octreotide and Conventional Imaging for Pulmonary and Gastroenteropancreatic Neuroendocrine Tumors: A Systematic Review and Meta-Analysis