Comparison of 68Ga-DOTATOC PET and 111In-DTPAOC (Octreoscan) SPECT in patients with neuroendocrine tumours

Buchmann, Inga; Henze, Marcus; Engelbrecht, Swantje; Eisenhut, Michael; Runz, A.; Schäfer, Martin; Schilling, Tobias; Haufe, Sabine; Herrmann, T; Haberkorn, Uwe

doi:10.1007/s00259-007-0450-1

Cited by 460 publications

(307 citation statements)

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“…Somatostatin receptor PET has shown promising results in NETs, with a higher lesion detection rate than is achieved with 18 F-fluorodihydroxyphenyl-L-alanine PET, somatostatin receptor SPECT, CT, or MR imaging (10,11,22,23). Currently, 68 Ga-DOTATOC, 68 Ga-DOTATATE, and 68 Ga-DOTANOC are the most established somatostatin receptor PET tracers (13 68 Ga-DOTATATE and 68 Ga-DOTANOC) showed a similar diagnostic accuracy for these tracers for the detection of NETs.…”

Section: Discussionmentioning

confidence: 99%

“…This finding is relevant because metallic 68 Ga is a positron emitter with a half-life of 68 min that is ideal for molecular PET imaging. Recently, somatostatin receptor PET using 68 Ga-DOTATOC or 68 Ga-DOTATATE showed promising results in patients, with a higher lesion detection rate than was achieved with 111 In-DTPA-octreotide scintigraphy and SPECT (10)(11)(12). But more important, somatostatin receptor PET changed the clinical management in most patients with negative or inconclusive findings on 111 In-DTPA-octreotide scintigraphy (12).…”

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confidence: 99%

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Comparison of ⁶⁸Ga-DOTANOC and ⁶⁸Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

et al. 2013

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Somatostatin receptor PET tracers such as [ 68 Ga-DOTA, 1-Nal 3 ]-octreotide ( 68 Ga-DOTANOC) and [ 68 Ga-DOTA,Tyr 3 ]-octreotate ( 68 Ga-DOTATATE) have shown promising results in patients with neuroendocrine tumors, with a higher lesion detection rate than is achieved with 18 F-fluorodihydroxyphenyl-Lalanine PET, somatostatin receptor SPECT, CT, or MR imaging. 68 Ga-DOTANOC has high affinity for somatostatin receptor subtypes 2, 3, and 5 (sst 2,3,5 ). It has a wider receptor binding profile than 68 Ga-DOTATATE, which is sst 2 -selective. The wider receptor binding profile might be advantageous for imaging because neuroendocrine tumors express different subtypes of somatostatin receptors. The goal of this study was to prospectively compare 68 Ga-DOTANOC and 68 Ga-DOTATATE PET/CT in the same patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and to evaluate the clinical impact of 68 Ga-DOTANOC PET/CT. Methods: Eighteen patients with biopsy-proven GEP-NETs were evaluated with 68 Ga-DOTANOC and 68 Ga-DOTATATE using a randomized crossover design. Labeling of DOTANOC and DOTATATE with 68 Ga was standardized using a fully automated synthesis device. PET/CT findings were compared with 3-phase CT scans and in some patients with MR imaging, 18 F-FDG PET/CT, and histology. Uptake in organs and tumor lesions was quantified and compared by calculation of maximum standardized uptake values (SUVmax) using volume computer-assisted reading. Results: Histology revealed low-grade GEP-NETs (G1) in 4 patients, intermediate grade (G2) in 7, and high grade (G3) in 7. 68 Ga-DOTANOC and 68 Ga-DOTATATE were false-negative in only 1 of 18 patients. In total, 248 lesions were confirmed by crosssectional and PET imaging. The lesion-based sensitivity of 68 Ga-DOTANOC PET was 93.5%, compared with 85.5% for 68 Ga-DOTATATE PET (P 5 0.005). The better performance of 68 Ga-DOTANOC PET is attributed mainly to the significantly higher detection rate of liver metastases rather than tumor differentiation grade. Multivariate analysis revealed significantly higher SUVmax in G1 tumors than in G3 tumors (P 5 0.009).This finding was less pronounced with 68 Ga-DOTANOC (P . 0.001). Altogether, 68 Ga-DOTANOC changed treatment in 3 of 18 patients (17%). Conclusion: The sst 2,3,5 -specific radiotracer 68 Ga-DOTANOC detected significantly more lesions than the sst 2 -specific radiotracer 68 Ga-DOTATATE in our patients with GEP-NETs. The clinical relevance of this finding has to be proven in larger studies.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Comparison of ⁶⁸Ga-DOTANOC and ⁶⁸Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

et al. 2013

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“…Thus, additional evidence of metastatic lesions was evident in O30%, particularly when localized within the skeletal system (Buchmann et al 2007), and localization of unknown primary NENs was established in 39% of cases (Prasad et al 2010). The superiority of 68 Ga-DOTA-based PET/CT over anatomic imaging using CT or MRI and its impact on treatment were demonstrated in a recent study on 52 NEN patients who underwent both standard morphological imaging and 68 Ga-DOTATOC PET/CT (Frilling et al 2010).…”

Section: R166mentioning

confidence: 99%

Neuroendocrine tumor disease: an evolving landscape

Frilling

Åkerström

Falconi

et al. 2012

Endocrine-Related Cancer

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Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) represent a heterogenous group of tumors arising from a variety of neuroendocrine cell types. The incidence and prevalence of GEPNENs have markedly increased over the last three decades. Symptoms are often absent in early disease, or vague and nonspecific even in advanced disease. Delayed diagnosis is thus common. Chromogranin A is the most commonly used biomarker but has limitations as does the proliferative marker Ki-67%, which is often used for tumor grading and determination of therapy. The development of a multidimensional prognostic nomogram may be valuable in predicting tumor behavior and guiding therapy but requires validation. Identification of NENs that express somatostatin receptors (SSTR) allows for SSTR scintigraphy and positron emission tomography imaging using novel radiolabeled compounds. Complete surgical resection of limited disease or endoscopic ablation of small lesions localized in stomach or rectum can provide cure; however, the majority of GEP-NENs are metastatic (most frequently the liver and/or mesenteric lymph nodes) at diagnosis. Selected patients with metastatic disease may benefit from advanced surgical techniques including hepatic resection or liver transplantation. Somatostatin analogs are effective for symptomatic treatment and exhibit some degree of antiproliferative activity in small intestinal NENs. There is a place for streptozotocin, temozolomide, and capecitabine in the management of pancreatic NENs, while new agents targeting either mTOR (everolimus) or angiogenic (sunitinib) pathways have shown efficacy in these lesions.

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“…Recent years have seen the development of other radiopharmaceuticals suitable for detecting NETs [14][15][16], but under certain circumstances, F-18-FDG PET can also be of diagnostic importance in NET patients with high proliferation index [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

The influence of Ki-67 proliferation index on Tc-99m-EDDA-HYNIC-TOC somatostatin receptor scintigraphy in patients with carcinoids

et al. 2014

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Abstract:The aim of this paper is to determine the influence of Ki-67 proliferation index on somatostatin receptor scintigraphy (SSRS) with Tc-99m-EDDA-HYNIC-TOC (Tc-99m-Tektrotyd) somatostatin analogue in patients with carcinoid tumors. Sixty-one patients (31 female, 30 male; age range: 33-76 years) were examined: 13 patients highly suspected of having a carcinoid, and 48 patients who had undergone the surgical removal of the tumor. Whole body SSRS at 4 h postinjection, spot scintigrams and SPECT of the selected regions were obtained for all patients. Tc-99m-Tektrotyd scintigraphy was classified as true positive in 26 out of 30 and true negative in 24 out of 28 patients. The sensitivity of Tc-99mTc-Tektrotyd scintigraphy was found to be as high as 94.74% in the group of patients with low mitotic index Ki67 (<2%), and it progressively decreased in patients with higher mitotic index (77.78% for Ki67 2-15% and 20% for Ki67% >20%). The likelihood of Tc-99m-Tektrotyd scan being positive when a carcinoid is present was found to be inversely proportional to the value of Ki67 proliferation index. The results showed that Tc-99m-Tektrotyd SSRS is a sensitive method for diagnosing and staging patients with well-differentiated carcinoid tumors. However, in poorly differentiated tumors with high Ki67 proliferation index, additional analyses are necessary for precise staging.

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Comparison of 68Ga-DOTATOC PET and 111In-DTPAOC (Octreoscan) SPECT in patients with neuroendocrine tumours

Cited by 460 publications

References 20 publications

Comparison of ⁶⁸Ga-DOTANOC and ⁶⁸Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

Comparison of ⁶⁸Ga-DOTANOC and ⁶⁸Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

Neuroendocrine tumor disease: an evolving landscape

The influence of Ki-67 proliferation index on Tc-99m-EDDA-HYNIC-TOC somatostatin receptor scintigraphy in patients with carcinoids

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Comparison of 68Ga-DOTATOC PET and 111In-DTPAOC (Octreoscan) SPECT in patients with neuroendocrine tumours

Cited by 460 publications

References 20 publications

Comparison of 68Ga-DOTANOC and 68Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

Comparison of 68Ga-DOTANOC and 68Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

Neuroendocrine tumor disease: an evolving landscape

The influence of Ki-67 proliferation index on Tc-99m-EDDA-HYNIC-TOC somatostatin receptor scintigraphy in patients with carcinoids

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Comparison of ⁶⁸Ga-DOTANOC and ⁶⁸Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

Comparison of ⁶⁸Ga-DOTANOC and ⁶⁸Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors