Standardized Uptake Values of <sup>68</sup>Ga-DOTANOC PET: A Promising Prognostic Tool in Neuroendocrine Tumors

Campana, Davide; Ambrosini, Valentina; Pezzilli, Raffaele; Fanti, Stefano; Labate, Antonio Maria Morselli; Santini, Donatella; Ceccarelli, Claudio; Nori, Francesca; Franchi, Roberto; Corinaldesi, Roberto; Tomassetti, Paola

doi:10.2967/jnumed.109.066662

Cited by 164 publications

(132 citation statements)

References 27 publications

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“…Still, whether 10 or 15 liver metastases are found is not necessarily important additional information. However, also when analyzing organ by organ, 58 additional organ systems were found to be involved in 40 patients when 64 Cu-DOTATATE was used, compared with 111 In-DTPA-OC, which could potentially be of importance for the prognosis (23,24) and treatment selection (25)(26)(27)(28). Nevertheless, more foci found by PET are not necessarily representative of true-positive foci.…”

Section: Discussionmentioning

confidence: 98%

⁶⁴Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with ¹¹¹In-DTPA-Octreotide in 112 Patients

et al. 2015

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Neuroendocrine tumors (NETs) can be visualized using radiolabeled somatostatin analogs. We have previously shown the clinical potential of 64 Cu-DOTATATE in a small first-in-human feasibility study. The aim of the present study was, in a larger prospective design, to compare on a head-to-head basis the performance of 64 In-diethylenetriaminepentaacetic acid (DTPA)-octreotide ( 111 In-DTPA-OC) as a basis for implementing 64 Cu-DOTATATE as a routine. Methods: We prospectively enrolled 112 patients with pathologically confirmed NETs of gastroenteropancreatic or pulmonary origin. All patients underwent both PET/CT with 64 Cu-DOTATATE and SPECT/CT with 111 In-DTPA-OC within 60 d. PET scans were acquired 1 h after injection of 202 MBq (range, 183-232 MBq) of 64 Cu-DOTATATE after a diagnostic contrast-enhanced CT scan. Patients were followed for 42-60 mo for evaluation of discrepant imaging findings. The McNemar test was used to compare the diagnostic performance. Results: Eightyseven patients were congruently PET-and SPECT-positive. No SPECT-positive cases were PET-negative, whereas 10 false-negative SPECT cases were identified using PET. The diagnostic sensitivity and accuracy of 64 Cu-DOTATATE (97% for both) were significantly better than those of 111 In-DTPA-OC (87% and 88%, respectively, P 5 0.017). In 84 patients (75%), 64 Cu-DOTATATE identified more lesions than 111 In-DTPA-OC and always at least as many. In total, twice as many lesions were detected with 64 Cu-DOTATATE than with 111 In-DTPA-OC. Moreover, in 40 of 112 cases (36%) lesions were detected by 64 Cu-DOTATATE in organs not identified as disease-involved by 111 In-DTPA-OC. Conclusion: With these results, we demonstrate that 64 Cu-DOTATATE is far superior to 111 In-DTPA-OC in diagnostic performance in NET patients. Therefore, we do not hesitate to recommend implementation of 64 Cu-DOTATATE as a replacement for 111 In-DTPA-OC.

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Section: Discussionmentioning

confidence: 98%

⁶⁴Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with ¹¹¹In-DTPA-Octreotide in 112 Patients

et al. 2015

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“…NENs constitute 0.66% of all malignancies in the United States, according to the Surveillance, Epidemiology, and End Results database, containing 48,195 NENs from 1970 to 2006, with an incidence increasing at a rate of 3%-10% per year (7). This increment is related to the introduction of more sensitive diagnostic tools and to an increased awareness by clinicians and pathologists (1,8).…”

Section: Clinical Scenariomentioning

confidence: 99%

Current Concepts in ⁶⁸Ga-DOTATATE Imaging of Neuroendocrine Neoplasms: Interpretation, Biodistribution, Dosimetry, and Molecular Strategies

et al. 2017

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CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA category 1 credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through November 2020.68 Ga-DOTATATE PET/CT provides information on the location of somatostatin receptor-expressing tumors. Integrating this imaging data effectively in patient care requires the clinical history; the histopathology and biomarker information; and the grade, stage, and prior imaging results. Previous therapies and technical aspects of the study should be considered, given their ability to alter the interpretation of the images. This includes physiologic biodistribution of the radiotracer, as well as conditions that engender false-positive results. This article provides a guide to the performance and interpretation of 68 Ga-DOTATATE PET/CT and describes its role in the diagnostic algorithm of neuroendocrine neoplasms and its overall utility in their management.

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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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Standardized Uptake Values of ⁶⁸Ga-DOTANOC PET: A Promising Prognostic Tool in Neuroendocrine Tumors

Cited by 164 publications

References 27 publications

⁶⁴Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with ¹¹¹In-DTPA-Octreotide in 112 Patients

⁶⁴Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with ¹¹¹In-DTPA-Octreotide in 112 Patients

Current Concepts in ⁶⁸Ga-DOTATATE Imaging of Neuroendocrine Neoplasms: Interpretation, Biodistribution, Dosimetry, and Molecular Strategies

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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Standardized Uptake Values of 68Ga-DOTANOC PET: A Promising Prognostic Tool in Neuroendocrine Tumors

Cited by 164 publications

References 27 publications

64Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with 111In-DTPA-Octreotide in 112 Patients

64Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with 111In-DTPA-Octreotide in 112 Patients

Current Concepts in 68Ga-DOTATATE Imaging of Neuroendocrine Neoplasms: Interpretation, Biodistribution, Dosimetry, and Molecular Strategies

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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Standardized Uptake Values of ⁶⁸Ga-DOTANOC PET: A Promising Prognostic Tool in Neuroendocrine Tumors

⁶⁴Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with ¹¹¹In-DTPA-Octreotide in 112 Patients

⁶⁴Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with ¹¹¹In-DTPA-Octreotide in 112 Patients

Current Concepts in ⁶⁸Ga-DOTATATE Imaging of Neuroendocrine Neoplasms: Interpretation, Biodistribution, Dosimetry, and Molecular Strategies

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