Correlation of 68Ga-DOTATATE uptake on PET/CT with pathologic features of cellular proliferation in neuroendocrine neoplasms

Karls, Shawn; Gold, Richard M.; Kravets, Sasha; Wang, Yating; Cheng, Su–Chun; Perez, Kimberly; Chan, Jennifer A.; Jacene, Heather A.

doi:10.1007/s12149-021-01642-3

Cited by 2 publications

(22 citation statements)

References 37 publications

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“…This study retrospectively retrieved 100 patients who underwent both 68 Ga-DOTATATE and 18 F-FDG PET/MR imaging in our center for evaluation of pancreatic or pancreatic-derived lesions from March 1, 2020, to June 20, 2021. This study was approved by the ethics committee of our hospital (IRB approval number: 2020-52), and all patients provided informed consent.…”

Section: Basic Information Of Patients and Lesionsmentioning

confidence: 99%

“…Most malignant tumors have increased glucose metabolism presenting as high FDG uptake. Although 18 F-FDG PET is not recommended for routine use in NENs, its application value in high-grade NENs (G3 NETs) has been gradually recognized (19,20). Studies have shown that the sensitivity of 18 F-FDG PET/CT imaging for G1/G2 GEP-NETs is only 40%-60%, but for G3 tumors it can be up to 95% (21,22).…”

Section: Introductionmentioning

confidence: 99%

“…Studies have shown that the sensitivity of 18 F-FDG PET/CT imaging for G1/G2 GEP-NETs is only 40%-60%, but for G3 tumors it can be up to 95% (21,22). Kayani et al reported that 18 F-FDG PET/CT and 68 Ga-DOTATATE PET/CT alone each have a sensitivity of 66% and 82%, respectively, while 18 F-FDG and 68 Ga-DOTATATE dual-tracer PET/CTs have an increased sensitivity of 92% (21). A higher 18 F-FDG uptake often indicates higher invasiveness and worse prognosis of NENs, and the combination of 68 Ga-DOTA-SSA and 18 F-FDG PET/CT imaging could improve prognosis predictions for NEN patients beyond that of the pathological grading system using WHO 2010 standard (23)(24)(25).…”

Section: Introductionmentioning

confidence: 99%

“…Recognizing the value of 18 F-FDG PET/CT in the diagnosis and classification of NENs, other multimodal imaging techniques have been developed for clinical application, in addition to the original 68 Ga-DOTA-SSA PET/CT imaging. However, there is still the important dilemma with balancing improved diagnostic efficiency with increased imaging cost and radiation exposure related to additional procedures.…”

Section: Introductionmentioning

confidence: 99%

“…However, there is still the important dilemma with balancing improved diagnostic efficiency with increased imaging cost and radiation exposure related to additional procedures. Therefore, the current study intends to determine the best imaging modality specifically for pNEN patients by comparing the diagnostic and grading efficiencies of various parameters of 68 Ga-DOTATATE and 18 F-FDG PET/MR, used either separately or in combination.…”

Section: Introductionmentioning

confidence: 99%

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The Diagnostic and Grading Accuracy of 68Ga-DOTATATE and 18F-FDG PET/MR for Pancreatic Neuroendocrine Neoplasms

et al. 2022

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Accurate diagnosis and grading are critical for pancreatic neuroendocrine neoplasm (pNEN) management. This study compares the diagnostic and grading value of 68Ga-DOTATATE PET/MR and 18F-FDG PET/MR for pNENs separately as well as in combination. A total of 36 patients with histologically confirmed pNENs, who underwent both 68Ga-DOTATATE PET/MR and 18F-FDG PET/MR within 2 weeks from 2020 to 2021, were retrospectively collected and analyzed. The maximum standardized uptake values of 68Ga-DOTATATE (G-SUVmax) and 18F-FDG (F-SUVmax) on PET and the minimum values of apparent diffusion coefficient (ADCmin) on MR were measured on the lesions with known histological grading (25 by surgery, 11 by biopsy). Receiver-operating characteristic analysis was applied to determine the cutoffs of these parameters or their combinations for differentiation between G1 and G2, as well as between low-grade and high-grade pNENs. The Spearman rank correlation coefficient was used to assess the correlation between the imaging parameters and the maximum tumor diameters. The detection rate of 68Ga-DOTATATE PET imaging alone was 95%, 87.5%, and 37.5% for G1, G2, and G3, respectively. Adding 18F-FDG PET or MR sequences of PET/MR increased the detection rate to 100% in all grades. Among the three parameters, G-SUVmax had the highest diagnostic rate in predicting tumor grade. It presented a sensitivity of 87.5% and a specificity of 80.0% with a cutoff value of 42.75 for differentiating G2 from G1 pNETs and a sensitivity and specificity of 100% and 71.4% with a cutoff value of 32.75 in predicting high-grade pNENs. The ratio of G-SUVmax to F-SUVmax (G-SUVmax/F-SUVmax) showed slight improvement in the diagnostic rate, while the product of G-SUVmax and ADCmin (G-SUVmax*ADCmin) did not improve the diagnostic rate. 68Ga-DOTATATE PET/MR alone is sufficient for the diagnosis of pNENs and the prediction of various grades.

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Section: Basic Information Of Patients and Lesionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Diagnostic and Grading Accuracy of 68Ga-DOTATATE and 18F-FDG PET/MR for Pancreatic Neuroendocrine Neoplasms

et al. 2022

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The comparison of three different molecular imaging methods in localization and grading of insulinoma

Chang,

Bi,

et al. 2023

Front. Endocrinol.

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AimsThis cross-sectional study compared the value of molecular imaging (Exendin-4 positron emission tomography/computed tomography [PET/CT], 68Ga-DOTATATE PET/CT, 18F- fluorodeoxyglucose [FDG] PET/CT) in insulinoma localization by stratified tumor size and grading, and explored the correlation of the related the maximum standardized uptake value (SUVmax) with insulinoma grading, Ki-67, maximum tumor diameter, and glucose metabolism.MethodsIn 28 insulinoma patients, the sensitivity of three types of PET/CT for localizing insulinoma was calculated according to tumor size and grade. We compared the SUVmax for different insulinoma grades and analyzed the correlation of SUVmax with Ki-67, maximum tumor diameter, and glucose metabolism indicators.ResultsThe study included 12 grade (G) 1 and 16 G2 cases, with maximum tumor diameters ranging from 9 to 40 mm. Without differentiation by size and grade, the sensitivity of Exendin-4 PET/CT to localize insulinoma was 100%, which significantly exceeded that of 68Ga-DOTATATE PET/CT and 18F-FDG PET/CT (75% and 57%, respectively). In tumors with a maximum diameter ≤ 20 mm and ≤ 15 mm, the sensitivity of Exendin-4 (both 100%) significantly exceeded that of 68Ga-DOTATATE PET/CT (74% and 64%, respectively) and 18F-FDG PET/CT (54% and 50%, respectively). In G1 tumors, the sensitivity of Exendin-4 PET/CT was significantly higher than that of 18F-FDG PET/CT, but not that of 68Ga-DOTATATE PET/CT, while in G2 tumors, the sensitivity of Exendin-4 PET/CT was significantly higher than that of both other types. However, all three PET/CT types missed a metastatic lymph node in one patient. The 18F-FDG PET/CT SUVmax was significantly lower than that of the other PET/CT types and that of 68Ga-DOTATATE PET/CT was significantly lower in G2 than in G1. 68Ga-DOTATATE PET/CT SUVmax correlated negatively with Ki-67. A receiver operating characteristic (ROC) curve suggested that 68Ga-DOTATATE PET/CT SUVmax > 19.9 could predict G1 tumors.ConclusionExendin-4 PET/CT was superior to 68Ga-DOTATATE PET/CT and 18F-FDG PET/CT for insulinoma localization, particularly small and G2 tumors, but its diagnostic value in small metastatic lymph nodes requires further exploration. 68Ga-DOTATATE PET/CT SUVmax could be used as an adjunct to pathology, and a value > 19.9 could predict G1 tumors. No PET/CT SUVmax could predict tumor maximum diameter and glucose metabolism.

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Correlation of 68Ga-DOTATATE uptake on PET/CT with pathologic features of cellular proliferation in neuroendocrine neoplasms

Cited by 2 publications

References 37 publications

The Diagnostic and Grading Accuracy of 68Ga-DOTATATE and 18F-FDG PET/MR for Pancreatic Neuroendocrine Neoplasms

The Diagnostic and Grading Accuracy of 68Ga-DOTATATE and 18F-FDG PET/MR for Pancreatic Neuroendocrine Neoplasms

The comparison of three different molecular imaging methods in localization and grading of insulinoma

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