Ga-68 DOTANOC PET/CT imaging in detection of primary site in patients with metastatic neuroendocrine tumours of unknown origin and its impact on clinical decision making: experience from a tertiary care centre in India

Pruthi, A. K.; Pankaj, Pankaj; Verma, Ritu; Jain, Anjali; Belho, Ethel Shangne; Mahajan, Harsh

doi:10.21037/jgo.2016.01.06

Cited by 22 publications

(22 citation statements)

References 38 publications

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“…In our study, the positive rates of Syn, NSE, CgA and AFP were separately 64.19%, 29.63%, 46.91% and 9.88% and there was no difference between the groups. It is reported 15 , 16 that the majority of the PHNETs occurred in the right lobe of the liver and the metastatic HNETs were proven to show a clinical tendency of the presentation of multifocality. We found that the III segment of the liver was the mostly-occurred site for the HNETs and there was no difference for the rate of multifocality between the groups (P=0.539).…”

Section: Discussionmentioning

confidence: 99%

“…Efforts were continuously made to identified the HNETs, Ankur 16 has reported the imaging features from Ga-68 PET/CT in 68 metastatic HNETs patients and indicated that Ga-68 PET/CT is a promising imaging modality in clinical practice for identifying the primary site of the HNETs, while some other scholars have analyzed 38 cases of PHNET with the dynamic contrast-enhanced CT findings, indicating that of which 74% of the lesions in the arterial phase were enhanced, 52% were found with delayed enhancement and 48% showed hepatocellular carcinoma-like enhancement 17 . Besides, Xiaoqi 18 suggested that the CDX-2 and TTF-1 expression in the specimen is highly specific in identifying the origin of NETs.…”

Section: Discussionmentioning

confidence: 99%

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Clinicopathological Characteristics of the primary and metastatic Hepatic Neuroendocrine Tumors and the relevant Prognosis-Related Factors: A Retrospective Study of 81 Cases in a Single Chinese Center

Huang

et al. 2018

J. Cancer

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Aims: We aim to describe the clinicopathological characteristics of hepatic neuroendocrine tumors (HNETs) and evaluate the relevant prognosis-related factors.Methods: The clinical data of 81 consecutive patients with primary or metastatic HNETs from March 2000 to July 2014 were retrospectively analyzed.Results: The mean (SD) age was 59.68 (11.64) years, 69.15% were men. The percentages of Grade G1, G2 and G3 tumors were 4.94%, 25.93% and 69.13%, respectively. Thirty-five cases were primary HNETs. Primary HNETs were more common in patients with larger tumors, lymph nodes invasions, tumor necrosis and portal vein tumor thrombus. The 1-, 3-, and 5-year overall survival rate were 88.89%, 32.10%, and 8.64%, separately. The relapse rate was 81.48% (66/81) and the mean (SD) relapse time was 18.79 (10.99) months. Reduced survival rate was associated with lymph node metastases (P=0.034), tumor necrosis (P=0.048), hard texture of tumor character (P=0.001), multifocality of tumor numbers (P=0.043), and the immunohistochemical expression of NSE (P=0.000) and Syn (P=0.037). Patients with metastatic HNETs were demonstrated with a more decreased period of Progression-free Survival (PFS) and Overall survival (OS) than their primary HNETs counterparts (P<0.05).Conclusion: Primary HNETs cohort patients were more common with aggressive clinical presentation. The hard texture of tumor character, multifocality of tumor numbers, and the immunohistochemical expression of NSE and Syn were independent predictive factors. Patients who were pathologically diagnosed as the primary HNETs seemed to achieve a long-term survival.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinicopathological Characteristics of the primary and metastatic Hepatic Neuroendocrine Tumors and the relevant Prognosis-Related Factors: A Retrospective Study of 81 Cases in a Single Chinese Center

Huang

et al. 2018

J. Cancer

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“…7 The NETs are characterized by the overexpression of somatostatin receptors (SSTRs). 8 Apart from malignant cells, these receptors are expressed by inflammatory cells and cells of the innate and adaptive immune system. 9 The SSTRs signal to alter hormonal secretion, augment apoptosis, and reduce cellular proliferation.…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of 99MTC-hynic-toc Scintigraphy in Lung Neuroendocrine Tumor Diagnosis

Boutsikou

Porpodis

Chatzipavlidou

et al. 2019

Technol Cancer Res Treat

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Background: Νeuroendocrine tumors of the lungs are rare arising in the thymus and gastro-entero-pancreatic tract and belonging to foregut of neuroendocrine tumors. The aim of the present prospective study was to estimate the potential impact of single-photon emission computed tomography somatostatin receptor scintigraphy using 99mTc-Tektrotyd on diagnosis, treatment response, and prognosis in patients with neuroendocrine tumors of the lungs. Methods: Thirty-six patients with neuroendocrine tumors of the lungs were evaluated by using 99mTc-HYNIC-TOC scintigraphy. The scintigraphic results were compared to liver tissue uptake (Krenning score). Likewise, the functional imaging results were compared with biochemical indices including chromogranin A, neuroendocrine-specific enolase, and insulin-like growth factor 1 at the time of diagnosis (baseline) and disease progression. Results: The number of somatostatin receptors, expressed with Krenning score, did not show any correlation with the survival of patients both at baseline ( P = .08) and at disease progression ( P = .24), and scintigraphy results did not relate significantly to progression-free survival. Comparing the results of 99mTc-HYNIC-TOC scintigraphy according to the response of patients in the initial treatment, a statistically significant negative correlation was observed both in the first and in the second scintigraphy with patients’ response ( P = .001 and P < .001, respectively). The concentrations of biochemical markers were in accordance with scintigraphy results in the diagnosis. Conclusion: This study indicates that 99mTc-HYNIC-TOC scintigraphy appears to be a reliable, noninvasive technique for detection of primary neuroendocrine tumors and their locoregional or distant metastases, although it cannot be used as a neuroendocrine tumors of the lungs predictive technique.

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“…PET/ CT with 68 Ga-DOTATATE plays a pivotal role in neuroendocrine tumor (NET) management (1), providing incremental data compared with 111 In-pentetreotide (Octreoscan; Mallinckrodt) and conventional imaging (2) and better sensitivity and specificity than 18 F-FDG PET imaging for neuroendocrine neoplasms (3,4). The clinical indications include primary tumor localization (5), metastatic disease detection, and response monitoring (6). In addition, somatostatin receptor (SSTR) imaging has established value in the prediction of response to treatment (7).…”

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confidence: 99%

Long-Acting Somatostatin Analog Therapy Differentially Alters⁶⁸Ga-DOTATATE Uptake in Normal Tissues Compared with Primary Tumors and Metastatic Lesions

et al. 2017

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Synthetic somatostatin analogs have been posed as a potential source of error in somatostatin receptor imaging through interference with tumor detection; however, experimental models and clinical studies have shown a complex mechanism of the effect of octreotide on tumors. The aim of this study was to assess whether Ga-DOTATATE uptake before treatment with long-acting somatostatin analogs differs from that after treatment. Thirty patients (15 men; age [mean ± SD], 64.6 ± 13.4 y) who had intermediately differentiated to well-differentiated neuroendocrine tumors and who underwent Ga-DOTATATE PET/CT scanning before and after receiving long-acting repeatable octreotide (Sandostatin LAR) were included in the study. The SUV and SUV of healthy target organs, residual primary tumor, and up to 5 lesions with the highest SUV in each organ were compared before and after octreotide treatment. The mean time interval between the 2Ga-DOTATATE studies was 9.6 ± 7.2 mo, and the mean time gap between the last Sandostatin LAR injection and the second Ga-DOTATATE study was 25.1 ± 14.8 d. The pretreatment mean SUV and SUV were both significantly higher in the thyroid, liver, and spleen ( < 0.05) than the values measured after the administration of Sandostatin LAR. No significant differences were found among the uptake indices for residual primary tumor or any metastatic lesions in the liver, bone, lung, or lymph nodes before and after Sandostatin LAR administration ( > 0.05). Long-acting octreotide treatment diminishedGa-DOTATATE uptake in the liver, spleen, and thyroid but did not compromise tracer uptake in residual primary tumor and metastatic lesions. These findings have a direct impact on the interpretation of Ga-DOTATATE PET/CT scans.

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Ga-68 DOTANOC PET/CT imaging in detection of primary site in patients with metastatic neuroendocrine tumours of unknown origin and its impact on clinical decision making: experience from a tertiary care centre in India

Cited by 22 publications

References 38 publications

Clinicopathological Characteristics of the primary and metastatic Hepatic Neuroendocrine Tumors and the relevant Prognosis-Related Factors: A Retrospective Study of 81 Cases in a Single Chinese Center

Clinicopathological Characteristics of the primary and metastatic Hepatic Neuroendocrine Tumors and the relevant Prognosis-Related Factors: A Retrospective Study of 81 Cases in a Single Chinese Center

Predictive Value of 99MTC-hynic-toc Scintigraphy in Lung Neuroendocrine Tumor Diagnosis

Long-Acting Somatostatin Analog Therapy Differentially Alters⁶⁸Ga-DOTATATE Uptake in Normal Tissues Compared with Primary Tumors and Metastatic Lesions

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Ga-68 DOTANOC PET/CT imaging in detection of primary site in patients with metastatic neuroendocrine tumours of unknown origin and its impact on clinical decision making: experience from a tertiary care centre in India

Cited by 22 publications

References 38 publications

Clinicopathological Characteristics of the primary and metastatic Hepatic Neuroendocrine Tumors and the relevant Prognosis-Related Factors: A Retrospective Study of 81 Cases in a Single Chinese Center

Clinicopathological Characteristics of the primary and metastatic Hepatic Neuroendocrine Tumors and the relevant Prognosis-Related Factors: A Retrospective Study of 81 Cases in a Single Chinese Center

Predictive Value of 99MTC-hynic-toc Scintigraphy in Lung Neuroendocrine Tumor Diagnosis

Long-Acting Somatostatin Analog Therapy Differentially Alters68Ga-DOTATATE Uptake in Normal Tissues Compared with Primary Tumors and Metastatic Lesions

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Long-Acting Somatostatin Analog Therapy Differentially Alters⁶⁸Ga-DOTATATE Uptake in Normal Tissues Compared with Primary Tumors and Metastatic Lesions