Detection of unknown primary neuroendocrine tumours (CUP-NET) using 68Ga-DOTA-NOC receptor PET/CT

Prasad, Vikas; Ambrosini, Valentina; Hommann, Merten; Hoersch, Dieter; Fanti, Stefano; Baüm, Richard

doi:10.1007/s00259-009-1205-y

Cited by 234 publications

(175 citation statements)

References 38 publications

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“…There are few reports of case series in the literature on patients with unknown primary tumors imaged with 68 Ga-DOTA-octreotide analogs (DOTATOC, DOTANOC, or DOTATATE). The largest study was reported by Prasad et al with 68 Ga-DOTANOC in 59 patients with metastatic NETs (17). In this latter study, the reported detectability of primary tumor with 68 Ga-DOTANOC was higher at 59%, although 49% of the positive scans for primary tumor were unconfirmed and surgical histopathology was available in 17% of patients.…”

Section: Discussionmentioning

confidence: 71%

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: Discussionmentioning

confidence: 71%

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

et al. 2017

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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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“…68 Ga-DOTANOC is a somatostatin analog radiotracer that, compared with other 68 Ga-DOTA peptides, shows improved affinity to somatostatin receptor (SSTR) type 2 and high affinity to types 3 and 5 (6)(7)(8). 68 Ga-DOTANOC PET/CT has been used for staging, restaging, controlling therapy, and detecting unknown primary tumors in patients with NET (9)(10)(11). Compared with other radiopharmaceuticals, such as 18 F-FDG and 18 F-3,4-dihydroxyphenylalanine (12)(13)(14), or other conventional imaging methods, such as CT or bone scanning (15,16), 68 Ga-DOTANOC has proved to be more accurate in the diagnosis of NET.…”

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confidence: 99%

Incidence of Increased ⁶⁸Ga-DOTANOC Uptake in the Pancreatic Head in a Large Series of Extrapancreatic NET Patients Studied with Sequential PET/CT

Castellucci¹,

Ucha²,

Fuccio³

et al. 2011

J Nucl Med

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The aim of our retrospective study was to assess the incidence of increased uptake of 68 Ga-DOTANOC in the head of the pancreas among a large population of patients with extrapancreatic neuroendocrine tumors studied with serial 68 Ga-DOTANOC PET/CT. Methods: Patients who had undergone at least two 68 Ga-DOTANOC PET/CT studies over time were included. Uptake in the head of the pancreas was measured and compared with uptake in normal liver parenchyma (target-to-liver ratio). Patients were followed up for 6-24 mo. Results: We reviewed 245 studies performed on 100 patients and classified the pancreatic uptake as either diffuse or focal. Twenty-three patients (66 scans) showed diffuse uptake; 8 patients (16 scans) showed focal uptake. None of these 31 patients had negative findings on their subsequent scans, and vice versa. During follow-up, localization of neuroendocrine tumors in the pancreas was not suspected in any patient. Conclusion: Focal and diffuse uptake of 68 Ga-DOTANOC in the head of the pancreas occurred, respectively, in 23% and 8% of the patients. The main finding of our study was that increased pancreatic uptake was stable over time.

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Detection of unknown primary neuroendocrine tumours (CUP-NET) using 68Ga-DOTA-NOC receptor PET/CT

Abstract: Our data indicate that (68)Ga-DOTA-NOC PET/CT is highly superior to (111)In-OctreoScan (39% detection rate for CUP according to the literature) and can play a major role in the management of patients with CUP-NET.

Cited by 234 publications

References 38 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

Neuroendocrine tumor disease: an evolving landscape

Incidence of Increased ⁶⁸Ga-DOTANOC Uptake in the Pancreatic Head in a Large Series of Extrapancreatic NET Patients Studied with Sequential PET/CT

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Detection of unknown primary neuroendocrine tumours (CUP-NET) using 68Ga-DOTA-NOC receptor PET/CT

Abstract: Our data indicate that (68)Ga-DOTA-NOC PET/CT is highly superior to (111)In-OctreoScan (39% detection rate for CUP according to the literature) and can play a major role in the management of patients with CUP-NET.

Cited by 234 publications

References 38 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

Neuroendocrine tumor disease: an evolving landscape

Incidence of Increased 68Ga-DOTANOC Uptake in the Pancreatic Head in a Large Series of Extrapancreatic NET Patients Studied with Sequential PET/CT

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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

Incidence of Increased ⁶⁸Ga-DOTANOC Uptake in the Pancreatic Head in a Large Series of Extrapancreatic NET Patients Studied with Sequential PET/CT