Imaging appearances of metastases from neuroendocrine tumours of the pancreas

Debray, Marie Pierre; Geoffroy, Olivier; Laissy, Jean-Pierre; Lebtahi, Rachida; Silbermann-Hoffman, O.; Henry–Feugeas, Marie-Cécile; Cadiot, Guillaume; Mignon, M; Schouman-Claeys, É.

doi:10.1259/bjr.74.887.741065

Cited by 87 publications

(51 citation statements)

References 6 publications

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“…However, the detection of bone metastases from carcinoid tumors by bone scintigraphy is hampered by several factors, such as the low resolution of planar scintigraphy (23). Furthermore, bone scintigraphy cannot always distinguish active metastases from a repair process.…”

Section: Discussionmentioning

confidence: 99%

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Bone Metastases in Patients with Neuroendocrine Tumor: ⁶⁸Ga-DOTA-Tyr³-Octreotide PET in Comparison to CT and Bone Scintigraphy

Putzer¹,

Gabriel²,

Henninger³

et al. 2009

J Nucl Med

189

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Somatostatin receptor scintigraphy is an accurate imaging modality for the diagnosis of neuroendocrine tumor. Because detection of distant metastases has a major impact on treatment, early diagnosis of metastatic spread is of great importance. So far, no standard procedure has become established for the early diagnosis of bone metastases from neuroendocrine tumor. We compared the diagnostic value of CT with that of the novel somatostatin analog 68 Ga-1,4,7,10-tetraazacyclododecane-N,N9,N$,N999-tetraacetic acid-D-Phe 1 -Tyr 3 -octreotide ( 68 Ga-DOTATOC) in the detection of such metastases. Methods: Fifty-one patients (22 women and 29 men; age range, 32-87 y) with histologically verified neuroendocrine tumor were included in this study. PET scans were fused with CT scans using a vacuum fixation device. 18 F-NaF or 99m Tc-dicarboxypropane diphosphonate bone scans or clinical follow-up served as the reference standard. Results: Twelve of the 51 patients had no evidence of bone metastases on any of the available imaging modalities, and 37 patients had 68 Ga-DOTATOC PET results true-positive for bone metastases. 68 Ga-DOTATOC PET results were true-negative for 12 patients, false-positive for one, and false-negative for another, resulting in a sensitivity of 97% and a specificity of 92%. 68 Ga-DOTATOC PET detected bone metastases at a significantly higher rate than did CT (P , 0.001). Furthermore, conventional bone scans confirmed the results of somatostatin receptor PET but did not reveal additional tumors in any patients. Conclusion: 68 Ga-DOTATOC PET is a reliable, novel method for the early detection of bone metastases in patients with neuroendocrine tumor. Our results show that CT and conventional bone scintigraphy are less accurate than 68 Ga-DOTATOC PET in the primary staging or restaging of neuroendocrine tumor.

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Section: Discussionmentioning

confidence: 99%

“…CT findings were considered positive if they corresponded to a specific, previously described appearance of malignant disease from neuroendocrine tumor (23).…”

Section: Image Interpretationmentioning

confidence: 99%

Bone Metastases in Patients with Neuroendocrine Tumor: ⁶⁸Ga-DOTA-Tyr³-Octreotide PET in Comparison to CT and Bone Scintigraphy

Putzer¹,

Gabriel²,

Henninger³

et al. 2009

J Nucl Med

189

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“…A positive diagnosis was based on the specific appearance of malignant disease derived from NET as reported elsewhere (18). Thus far, abnormal findings were assessed histologically in 13 patients.…”

Section: Interpretation and Data Evaluationmentioning

confidence: 99%

68Ga-DOTA-Tyr3-Octreotide PET in Neuroendocrine Tumors: Comparison with Somatostatin Receptor Scintigraphy and CT

Gabriel¹,

Decristoforo²,

Kendler³

et al. 2007

Journal of Nuclear Medicine

913

557

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The aim of this study was to evaluate the diagnostic value of a new somatostatin analog, 68 Ga-labeled 1,4,7,10-tetraazacyclododecane-N,N9,N$,N$9-tetraacetic acid-D-Phe 1 -Tyr 3 -octreotide ( 68 Ga-DOTA-TOC), for PET in patients with known or suspected neuroendocrine tumors. PET was compared with conventional scintigraphy and dedicated CT. Methods: Eighty-four patients (48 men, 36 women; age range, 28-79 y; mean age 6 SD, 58.2 6 12.2 y) were prospectively studied. For analysis, patients were divided into 3 groups: detection of unknown primary tumor in the presence of clinical or biochemical suspicion of neuroendocrine malignancy (n 5 13 patients), initial tumor staging (n 5 36 patients), and follow-up after therapy (n 5 35 patients). Each patient received 100-150 MBq 68 Ga-DOTA-TOC. Imaging results of PET were compared with 99m Tc-labeled hydrazinonicotinyl-Tyr 3 -octreotide ( 99m Tc-HYNIC-TOC) and 111 In-DOTA-TOC. CT was also performed on every patient using a multidetector scanner. Each imaging modality was interpreted separately by observers who were unaware of imaging findings before comparison with PET. The gold standard for defining true-positive (TP), true-negative (TN), false-positive (FP), and false-negative (FN) results was based on all available histologic, imaging, and follow-up findings. Results: PET was TP in 69 patients, TN in 12 patients, FP in 1 patient, and FN in 2 patients, indicating a sensitivity of 97%, a specificity of 92%, and an accuracy of 96%. The FP finding was caused by enhanced tracer accumulation in the pancreatic head, and the FN results were obtained in patients with a tumor of the gastrointestinal tract displaying liver metastases. 68 Ga-DOTA-TOC showed higher diagnostic efficacy compared with SPECT (TP in 37 patients, TN in 12 patients, FP in 1 patient, and FN in 34 patients) and diagnostic CT (TP in 41 patients, TN in 12 patients, FP in 5 patients, and FN in 26 patients). This difference was of statistical significance (P , 0.001). However, the combined use of PET and CT showed the highest overall accuracy. Conclusion: 68 Ga-DOTA-TOC PET shows a significantly higher detection rate compared with conventional somatostatin receptor scintigraphy and diagnostic CT with clinical impact in a considerable number of patients.

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“…Interestingly, 15% of cases showed increased enhancement only in the arterial phase. Furthermore, some of the metastases may display T2 hyperintensity approaching that of hemangiomas [37] . Nevertheless, T2WI and hepatic arterial phase T1WI fat-suppressed imaging have been shown to be most sensitive [38] .…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Imaging of gastroenteropancreatic neuroendocrine tumors

Tan

Tan²

2011

WJCO

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Imaging of gastroenteropancreatic neuroendocrine tumors can be broadly divided into anatomic and functional techniques. Anatomic imaging determines the local extent of the primary lesion, providing crucial information required for surgical planning. Functional imaging, not only determines the extent of metastatic disease spread, but also provides important information with regard to the biologic behavior of the tumor, allowing clinicians to decide on the most appropriate forms of treatment. We review the current literature on this subject, with emphasis on the strengths of each imaging modality.

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Imaging appearances of metastases from neuroendocrine tumours of the pancreas

Cited by 87 publications

References 6 publications

Bone Metastases in Patients with Neuroendocrine Tumor: ⁶⁸Ga-DOTA-Tyr³-Octreotide PET in Comparison to CT and Bone Scintigraphy

Bone Metastases in Patients with Neuroendocrine Tumor: ⁶⁸Ga-DOTA-Tyr³-Octreotide PET in Comparison to CT and Bone Scintigraphy

68Ga-DOTA-Tyr3-Octreotide PET in Neuroendocrine Tumors: Comparison with Somatostatin Receptor Scintigraphy and CT

Imaging of gastroenteropancreatic neuroendocrine tumors

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Imaging appearances of metastases from neuroendocrine tumours of the pancreas

Cited by 87 publications

References 6 publications

Bone Metastases in Patients with Neuroendocrine Tumor: 68Ga-DOTA-Tyr3-Octreotide PET in Comparison to CT and Bone Scintigraphy

Bone Metastases in Patients with Neuroendocrine Tumor: 68Ga-DOTA-Tyr3-Octreotide PET in Comparison to CT and Bone Scintigraphy

68Ga-DOTA-Tyr3-Octreotide PET in Neuroendocrine Tumors: Comparison with Somatostatin Receptor Scintigraphy and CT

Imaging of gastroenteropancreatic neuroendocrine tumors

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Bone Metastases in Patients with Neuroendocrine Tumor: ⁶⁸Ga-DOTA-Tyr³-Octreotide PET in Comparison to CT and Bone Scintigraphy

Bone Metastases in Patients with Neuroendocrine Tumor: ⁶⁸Ga-DOTA-Tyr³-Octreotide PET in Comparison to CT and Bone Scintigraphy