Al[18F]F-NOTA-Octreotide Is Comparable to [68Ga]Ga-DOTA-TATE for PET/CT Imaging of Neuroendocrine Tumours in the Latin-American Population

Abstract

PET imaging of neuroendocrine tumours (NET) is well established for staging and therapy follow-up. The short half-life, increasing costs, and regulatory issues significantly limit the availability of approved imaging agents, such as [68Ga]Ga-DOTA-TATE. Al[18F]F-NOTA-Octreotide provides a similar biodistribution and tumour uptake, can be produced on a large scale and may improve access to precision imaging. Here we prospectively compared the clinical utility of [68Ga]Ga-DOTA-TATE and Al[18F]F-NOTA-Octreotide in the Latin-American population. Our results showed that in patients with stage IV NETs [68Ga]Ga-DOTA-TATE presents higher physiological uptake than Al[18F]F-NOTA-Octreotide in the liver, hypophysis, salivary glands, adrenal glands (all p < 0.001), pancreatic uncinated process, kidneys, and small intestine (all p < 0.05). Nevertheless, despite the lower background uptake of Al[18F]F-NOTA-Octreotide, comparative analysis of tumour-to-liver (TLR) and tumour-to-spleen (TSR) showed no statistically significant difference for lesions in the liver, bone, lymph nodes, and other tissues. Only three discordant lesions in highly-metastases livers were detected by [68Ga]Ga-DOTA-TATE but not by Al[18F]F-NOTA-Octreotide and only one discordant lesion was detected by Al[18F]F-NOTA-Octreotide but not by [68Ga]Ga-DOTA-TATE. Non-inferiority analysis showed that Al[18F]F-NOTA-Octreotide is comparable to [68Ga]Ga-DOTA-TATE. Hence, our results demonstrate that Al[18F]F-NOTA-Octreotide provided excellent image quality, visualized NET lesions with high sensitivity and represents a highly promising, clinical alternative to [68Ga]Ga-DOTA-TATE.

Tumores Neuroendócrinos Pancreáticos: Revisão Histopatológica

“…Na prática diária esta revisão histopatológica pode ser de ajuda tanto para clínicos como para oncologistas, lembrando que em indivíduos assintomáticos os achados histopatológicos incidentais com presença de biomarcadores, como a sinaptofisina e cromogranina-A, além da avidez difusa na cintilografia com octreotídeo, são preditores de TNEPs bem diferenciados. 5 Já quando existem sintomas associados à malignidade, os marcadores plasmáticos para carcinoma -exemplo o antígeno carcinoembrionário -encontram-se elevados, e se for detectada somente atividade focal, fraca ou negativa na cintilografia com octreotídeo, a conclusão…”

Clinical impact of using [18F]AlF‐NOTA‐octreotide PET/CT instead of [68Ga]Ga‐DOTA‐SSA PET/CT: Secondary endpoint analysis of a multicenter, prospective trial

“…8 Studies comparing [ 18 F] AlF-OC with [ 68 Ga]Ga-DOTA-SSA PET/CT imaging have shown a favorable biodistribution, dosimetry, tumor uptake, and safety profile for [ 18 F]AlF-OC. 1,[9][10][11][12] We have previously demonstrated in a prospective, multicenter trial comparing both tracers that [ 18 F]AlF-OC is superior in terms of lesion detection compared to [ 68 Ga]Ga-DOTA-SSAs. 1 In this study with 75 patients who received both [ 18 F]AlF-OC and [ 68 Ga]Ga-DOTA-SSA PET/CT, we found a difference in detection ratio of 15.8% (91.1% vs. 75.3%, respectively) between both tracers and a higher tumor-to-background ratio in favor of [ 18 F]AlF-OC.…”

“…Recently, a GMP‐compliant, chelator‐based, automated radiolabeling method for [ 18 F]AlF‐NOTA‐octreotide ([ 18 F]AlF‐OC), an Al 18 F‐labeled SSTR agonist, has been described 8 . Studies comparing [ 18 F]AlF‐OC with [ 68 Ga]Ga‐DOTA‐SSA PET/CT imaging have shown a favorable biodistribution, dosimetry, tumor uptake, and safety profile for [ 18 F]AlF‐OC 1,9–12 . We have previously demonstrated in a prospective, multicenter trial comparing both tracers that [ 18 F]AlF‐OC is superior in terms of lesion detection compared to [ 68 Ga]Ga‐DOTA‐SSAs 1 .…”

18F-Labeled Somatostatin Analogs as PET Tracers for the Somatostatin Receptor: Ready for Clinical Use

“…This can most likely be attributed to tumor heterogeneity and differences in SSTR affinity (31). In a recently published prospective trial with 20 NET patients, noninferiority of [ 18 F]AlF-NOTA-octreotide in comparison with [ 68 Ga]Ga-DOTATATE was confirmed (32).…”

“…Differences in lesion detection rate and tumor-to-background ratios were nonsignificant, but [ 18 F]AlF-NOTA-octreotide images showed lower liver and spleen background, providing excellent image quality (32).…”