Neuroendocrine Tumor Diagnosis and Management: ⁶⁸Ga-DOTATATE PET/CT

Abstract

In combination with FDG PET/CT, Ga-DOTATATE PET/CT can noninvasively assess tumor heterogeneity, especially in G2 and G3 NETs, for personalized management of patients.

Islets of hypoglycaemia: a rare case of adult onset nesidioblastosis

“…8 Several studies have shown the high diagnostic accuracy of 68Ga-DOTATATE PET/CT in diagnosis of primary NETs compared with conventional imaging modalities. 4 The sst2,3,5-specific radiotracer 68Ga-DOTANOC detected significantly more lesions than sst2-specific radiotracer 68Ga-DOTATATE in with GEP-NETs. 5 A study using F18-fluorodihydroxyphenylalanine (F-DOPA) PET scan has been used to detect the hyper functional pancreatic islet tissue and to differentiate between focal and diffuse variants of nesidioblastosis with a reported accuracy of 96% in diagnosing focal or diffuse disease.…”

“…According to American journal of nuclear medicine and molecular imaging 2018, Gallium-68 DOTATATE PET/CT is an advanced functional imaging modality for non-invasive assessment of well-differentiated NETs. 4 The sst2,3,5specific radiotracer 68Ga-DOTANOC detected significantly more lesions than sst2-specific radiotracer 68Ga-DOTATATE in with GEP-NETs in a study by Wild D et al 5 A Ga68 DOTANOC PET CT was done, which showed ill-defined diffuse somatostatin receptor expression in the pancreatic head and tail suggestive of nesidioblastosis ( Figure 3).…”

An improved automated radiosynthesis of [18F]FET-βAG-TOCA

“…68 Ga-DOTATATE) are routinely used in the clinic, however fluorine-18 analogues may be more useful as a result of the longer half-life of fluorine-18 (t1/2 = 110 min vs. 68 min) and the ability to produce multipatient doses from cyclotron-generated [ 18 F]fluoride. [2][3][4] We have previously reported the development of a novel 18 Fradiolabelled octreotide radioligand ([ 18 F]FET-AG-TOCA, Scheme 1B) targeting somatostatin receptor type 2 (SSTR-2) which was radiolabelled using copper(I) catalysed Husigen azide-alkyne 1,3-dipolar cycloaddition (CuAAC "click") chemistry between an alkyne-bearing peptide and 2-[ 18 F]fluoroethylazide ([ 18 F]FEA, Scheme 1A). 4,5 With a first-inhuman study, we confirmed the distribution, dosimetry and safety of [ 18 F]FET-AG-TOCA in patients bearing NETs.…”

PET/MRI in Neuroendocrine Tumours: Blessings and Curses

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Neuroendocrine Tumours (NETs) include a variety of tumour types, having small bowel and pancreas as the most frequent sites of origin [1].The precise definition of the extent of disease is of utmost relevance for therapy decision, as near-total resection has been demonstrated to correlate with good-long-term outcomes [2].The most common pathway of metastatisation of abdominal NETs flows from the nodal disease to the liver, therefore one of the major goals of using cross-sectional imaging is to detect the primary lesion and hepatic metastases [3].Currently, Positron Emission Tomography/Computed Tomography (PET/CT) with radiolabelled Somatostatin Receptors (SSTR) analogues is considered as standard imaging to be performed for staging and treatment monitoring of NETs [4].Magnetic Resonance Imaging (MRI) offers well-known advantages over CT imaging for its superb soft tissue contrast and Diffusion-Weighted Imaging (DWI) is an invaluable tool to depict small liver lesions not detected on PET or CT; moreover, the possibility to combine 3-Tesla and DWI, together with the administration of liver specific contrast media may provide further improvement of sensitivity and specificity in detecting small hepatic metastases [5][6][7].Therefore, fully integrated PET/MRI systems that have been quite recently introduced in clinical practice represent a powerful technology to be applied in the field of NETs.

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“…Currently, Positron Emission Tomography/Computed Tomography (PET/CT) with radiolabelled Somatostatin Receptors (SSTR) analogues is considered as standard imaging to be performed for staging and treatment monitoring of NETs [4].…”