Comparison of abdominal MRI with diffusion-weighted imaging to 68Ga-DOTATATE PET/CT in detection of neuroendocrine tumors of the pancreas

Schmid-Tannwald, Christine; Schmid-Tannwald, C.; Morelli, John N.; Neumann, Ralph; Haug, Alexander; Jansen, Nathalie; Nikolaou, Konstantin; Schramm, Nicolai; Reiser, Maximilian; Rist, Carsten

doi:10.1007/s00259-013-2371-5

Cited by 77 publications

(41 citation statements)

References 35 publications

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“…Retrospective analysis of the dedicated CT scan demonstrated a 0.4-cm lesion, which is in accordance with the theory that subcentimeter lesions, even when below the spatial resolution of the equipment, may be detected because of the markedly high 68 Ga-DOTATATE uptake. In addition, as seen in prior reports (20), there was a significant difference in lesion detectability in the pancreas between 68 Ga-DOTATATE PET/CT and WB DWI or SSRS SPECT/CT.…”

Section: Figuresupporting

confidence: 78%

⁶⁸Ga-DOTATATE PET/CT, ^99mTc-HYNIC-Octreotide SPECT/CT, and Whole-Body MR Imaging in Detection of Neuroendocrine Tumors: A Prospective Trial

et al. 2014

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There are different metabolic imaging methods, various tracers, and emerging anatomic modalities to stage neuroendocrine tumor (NET). We aimed to compare NET lesion detectability among 99m Tchydrazinonicotinamide (HYNIC)-octreotide (somatostatin receptor scintigraphy [SSRS]) SPECT/CT, 68 Ga-DOTATATE PET/CT, and whole-body diffusion-weighted MR imaging (WB DWI). Methods: Nineteen consecutive patients (34-77 y old; mean, 54.3 ± 10.4 y old; 10 men and 9 women) underwent SSRS SPECT/CT, 68 Ga-DOTATATE PET/CT, and WB DWI. Images were acquired with a maximum interval of 3 mo between them and were analyzed with masking by separate teams. Planar whole-body imaging and SPECT/CT were performed from thorax to pelvis using a double-head 16-slice SPECT/CT scanner 4 h after injection of 111-185 MBq of 99m Tc-HYNIC-octreotide. 68 Ga-DOTATATE PET/CT was performed from head to feet using a 16-slice PET/CT scanner 45 min after injection of 185 MBq of tracer. WB DWI was performed in the coronal plane using a 1.5-T scanner and a body coil. The standard method of reference for evaluation of image performance was undertaken: consensus among investigators at the end of the study, clinical and imaging follow-up, and biopsy of suggestive lesions. Results: McNemar testing was applied to evaluate the detectability of lesions using 68 Ga-DOTATATE PET/CT in comparison to SSRS SPECT/CT and WB DWI: a significant difference in detectability was noted for pancreas (P 5 0.0455 and P 5 0.0455, respectively), gastrointestinal tract (P 5 0.0455 and P 5 0.0455), and bones (P 5 0.0082 and P 5 0.0082). Two unknown primary lesions were identified solely by 68 Ga-DOTATATE PET/CT. 68 Ga-DOTATATE PET/CT, SSRS SPECT/CT, and WB DWI demonstrated, respectively, sensitivities of 0.96, 0.60, and 0.72; specificities of 0.97, 0.99, and 1.00; positive predictive values of 0.94, 0.96, and 1.00; negative predictive values of 0.98, 0.83, and 0.88; and accuracies of 0.97, 0.86, and 0.91. Conclusion: 68 Ga PET/CT seems to be more sensitive for detection of well-differentiated NET lesions, especially for bone and unknown primary lesions. NET can be staged with 68 Ga-DOTATATE PET/CT. WB DWI is an efficient new method with high accuracy and without ionizing radiation exposure. SSRS SPECT/CT should be used only when 68 Ga-DOTATATE PET/CT and WB DWI are not available.

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Section: Figuresupporting

confidence: 78%

⁶⁸Ga-DOTATATE PET/CT, ^99mTc-HYNIC-Octreotide SPECT/CT, and Whole-Body MR Imaging in Detection of Neuroendocrine Tumors: A Prospective Trial

et al. 2014

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“…However, it is increasingly being used in body applications for the detection and characterization of pancreatic lesions and for the assessment of hepatic metastases. Despite this fact, relatively few studies, including small numbers of patients, have been conducted regarding its usefulness in the evaluation of patients with PanNENs [13,14,15,16,17,18,19,20,21], and they provided somehow contradictory results.…”

Section: Introductionmentioning

confidence: 99%

Pancreatic Neuroendocrine Neoplasms: Clinical Value of Diffusion-Weighted Imaging

et al. 2015

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Background/Aims: Diffusion-weighted imaging (DWI) can depict random motions of water molecules in biological tissues during magnetic resonance (MR) examinations. Few papers have tested its application to pancreatic neuroendocrine neoplasms (PanNENs). The aim of this paper is to assess the clinical value of DWI regarding the identification and characterization of PanNENs and diagnosis of liver metastases. Methods: Preoperative MR examinations of 30 PanNEN patients were retrospectively reviewed; 30 patients with pathologically proven pancreatic ductal adenocarcinoma (PDAC) were included to compare the imaging features. Qualitative and quantitative MR features were compared between histotypes. A blinded-reader comparison of diagnostic confidence for PanNENs and liver metastases was conducted on randomized image sets. All results were compared with pathological data. Results: PanNEN conspicuity was higher on DW images compared to conventional MR sequences. DWI had higher detection rates for PanNENs than had conventional sequences (93.3 vs. 71.1%). Sharp margins and absence of main pancreatic duct/common bile duct dilation and chronic pancreatitis were more common among PanNENs as compared to PDACs. Arterial iso- or hyperenhancement and portal hyperenhancement were more frequent within PanNENs as compared to PDACs. No differences between histotypes were found for quantitative features. Arterial-phase images had the highest interobserver agreement for the diagnosis of PanNEN (Cohen's κ = 0.667). DWI provided the highest detection rate for liver metastases as well as excellent interobserver agreement for the diagnosis of liver metastases (κ = 0.932), with good accuracy (AUC = 0.879-0.869). Conclusion: DWI has clinical value regarding the identification of PanNENs and the diagnosis of liver metastases, while conventional MR sequences are fundamental for their characterization.

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“…This method seems to be more sensitive Case report than F-FDG PET-CT and magnetic resonance imaging in the initial staging of PNENs, response evaluation and follow-up [23,24]. In our case, 68 Ga-DOTATATE PET allowed early detection of tumor progression in the liver.…”

mentioning

confidence: 88%

Problems of diagnostic assessment in advanced pancreatic neuroendocrine neoplasm and treatment implications: a case report and literature review

et al. 2016

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We are reporting a case of a 55-year-old woman who was diagnosed as having a non-functioning pancreatic neuroendocrine neoplasm (NF-PNEN), the World Health Organization (WHO) low grade (G1) with liver metastases. In the staging process the Then, due to disease progression -radioisotope therapy with b-emitter Yttrium-90 ( 90 Y). Based on this experience and on the review of the literature, we recommend that the discrepancy between the imaging studies could be due to heterogeneity of proliferation rate and somatostatin receptors (SSTR) expression within a primary PNEN and metastases. Therefore in such cases of advanced PNEN WHO G1 in the lack of response to everolimus and octreotide LAR administration isotope therapy without a prior chemotherapy should be considered as a palliative treatment according to ESMO Clinical Practice Guidelines and Polish Network of Neuroendocrine Tumors.

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Comparison of abdominal MRI with diffusion-weighted imaging to 68Ga-DOTATATE PET/CT in detection of neuroendocrine tumors of the pancreas

Abstract: DW MRI is a valuable adjunct to T2w imaging and comparable to CE T1w imaging in pancreatic NET detection, quantitatively differentiating between NET and normal pancreatic tissue with ADC measurements. (68)Ga-DOTATATE PET/CT is more sensitive than MRI in the detection of pancreatic NET.

Cited by 77 publications

References 35 publications

⁶⁸Ga-DOTATATE PET/CT, ^99mTc-HYNIC-Octreotide SPECT/CT, and Whole-Body MR Imaging in Detection of Neuroendocrine Tumors: A Prospective Trial

⁶⁸Ga-DOTATATE PET/CT, ^99mTc-HYNIC-Octreotide SPECT/CT, and Whole-Body MR Imaging in Detection of Neuroendocrine Tumors: A Prospective Trial

Pancreatic Neuroendocrine Neoplasms: Clinical Value of Diffusion-Weighted Imaging

Problems of diagnostic assessment in advanced pancreatic neuroendocrine neoplasm and treatment implications: a case report and literature review

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Comparison of abdominal MRI with diffusion-weighted imaging to 68Ga-DOTATATE PET/CT in detection of neuroendocrine tumors of the pancreas

Abstract: DW MRI is a valuable adjunct to T2w imaging and comparable to CE T1w imaging in pancreatic NET detection, quantitatively differentiating between NET and normal pancreatic tissue with ADC measurements. (68)Ga-DOTATATE PET/CT is more sensitive than MRI in the detection of pancreatic NET.

Cited by 77 publications

References 35 publications

68Ga-DOTATATE PET/CT, 99mTc-HYNIC-Octreotide SPECT/CT, and Whole-Body MR Imaging in Detection of Neuroendocrine Tumors: A Prospective Trial

68Ga-DOTATATE PET/CT, 99mTc-HYNIC-Octreotide SPECT/CT, and Whole-Body MR Imaging in Detection of Neuroendocrine Tumors: A Prospective Trial

Pancreatic Neuroendocrine Neoplasms: Clinical Value of Diffusion-Weighted Imaging

Problems of diagnostic assessment in advanced pancreatic neuroendocrine neoplasm and treatment implications: a case report and literature review

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⁶⁸Ga-DOTATATE PET/CT, ^99mTc-HYNIC-Octreotide SPECT/CT, and Whole-Body MR Imaging in Detection of Neuroendocrine Tumors: A Prospective Trial

⁶⁸Ga-DOTATATE PET/CT, ^99mTc-HYNIC-Octreotide SPECT/CT, and Whole-Body MR Imaging in Detection of Neuroendocrine Tumors: A Prospective Trial