PET/CT and PET/MRI in neuroendocrine neoplasms

Rajamohan, Naveen; Khasawneh, Hala; Singh, Aparna; Suman, Garima; Johnson, Geoffrey B.; Majumder, Shounak; Halfdanarson, Thorvardur R.; Goenka, Ajit H.

doi:10.1007/s00261-022-03516-2

Cited by 11 publications

(2 citation statements)

References 82 publications

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“…In addition, there has also been a significant increase in diagnostic and therapeutic options for these patients 10 . This includes the use of gallium‐68 DOTA‐Tyr3‐octreotate (DOTATATE), which received Food and Drug Administration approval in 2016 11,12 . Since then, DOTATATE positron emission tomography (PET) imaging has been more commonly utilized due to its presumed high diagnostic accuracy and ability to detect additional intra and extrahepatic metastatic disease that was previously undetected by conventional computed tomography (CT) and magnetic resonance imaging (MRI) 13 .…”

Section: Introductionmentioning

confidence: 99%

“…10 This includes the use of gallium-68 DOTA-Tyr3-octreotate (DOTATATE), which received Food and Drug Administration approval in 2016. 11,12 Since then, DOTATATE positron emission tomography (PET) imaging has been more commonly utilized due to its presumed high diagnostic accuracy and ability to detect additional intra and extrahepatic metastatic disease that was previously undetected by conventional computed tomography (CT) and magnetic resonance imaging (MRI). 13 However, the accuracy of DOTATATE PET imaging for preoperative surgical planning for the management of local or regional sbNET disease remains unproven.…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of DOTATATE PET imaging in the preoperative planning of small bowel neuroendocrine tumor resection

Zhang,

Gudmundsdottir,

Takahashi

et al. 2023

Journal of Surgical Oncology

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Background and ObjectivesWe assessed the accuracy of preoperative gallium‐68 DOTA‐Tyr3‐octreotate (DOTATATE) positron emission tomography (PET) imaging in estimating multifocality and nodal metastases of small bowel neuroendocrine tumors (sbNETs).MethodsA multicenter analysis was performed on patients with sbNETs who underwent preoperative DOTATATE PET imaging and surgical resection, with manual palpation of the entire length of the small bowel, between January 2016 and August 2022. Preoperative imaging reports and blinded secondary imaging reviews were compared to the final postoperative pathology reports. Descriptive statistics were applied.ResultsOne‐hundred and four patients met inclusion criteria. Pathology showed 53 (51%) patients had multifocal sbNETs and 96 (92%) had nodal metastases. The original preoperative DOTATATE PET imaging identified multifocal sbNET in 28 (27%) patients and lymph node (LN) metastases in 80 (77%) patients. Based on original radiology reports, sensitivity for multifocal sbNET identification was 45%, specificity was 92%, positive predictive value (PPV) was 86%, and negative predictive value (NPV) was 62%. For the identification of LN metastases, sensitivity was 82%, specificity was 88%, PPV was 99%, and NPV was 29%.ConclusionsAlthough DOTATATE PET imaging is specific and relatively accurate, sensitivity and NPV are insufficient to guide surgical planning. Preoperative use should not replace open palpation to identify additional synchronous lesions or to omit regional lymphadenectomy.

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Section: Introductionmentioning

confidence: 99%