AOJNMB , AOFNMB , MUMS

68Ga-DOTATATE Radioisotope scan to detect neuroendocrine tumors; A Cross-Sectional Study

Document Type : Original Article

Authors

Chronic Respiratory Diseases Research Center, National research institute of tuberculosis and lung diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Objevtive(s): Neuroendocrine tumors are a heterogeneous group of neoplasms that arise from the peptide-producing cells of the neuroendocrine system. Different functional imaging methods have been suggested to diagnose NETs. There is still not enough evidence to recommend 68Ga-DOTATATE as a standard diagnostic tool in NETs. Therefore, the aim of this study was to assess the value of 68Ga-DOTATATE scan in detecting NETs.
Methods: This was a cross-sectional study. All patients with a pathologically confirmed NET tumor referred to Masih Daneshvari Hospital affiliated to Shahid Beheshti University of Medical Sciences entered the study. Patients underwent a 68Ga-DOTATATE PET/CT. All statistical analysis were performed by SPSS software version 18.
Results: Forty patients with a mean age of 48.1±15.80 years entered the study. Twenty-one (52.5%) were male and 19 (47.5%) female. In the studied patients, neuroendocrine tumor was present in 19 cases (47.5%) in pancreas and gastrointestinal tract, 9 (22.5%) in lung, 3 (7.5%) in mediastinum and adrenal gland, 6 cases (5%) in liver and 3 other sites. There was no significant association between mean age and gender with primary location of the tumor. The mean
SUVmax was 11.62±20.02 and the the mean tumor size was 38.25±31.35 mm. The mean size of the metastasis was 40.55±24.53 mm. The mean percentage of ki-67 was 12.54±18.40. There was no significant correlation between SUVmax of the lesion and age (r=0.063, P=0.701), tumor size (r=-0.63, P=0.067) or Ki-67 (r=0.011, P=0.960). In 20 cases, metastases were reported, of which 14 were (70%) in the liver, 3 in the lungs (15%), 2 in the gastrointestinal and cervical lymph nodes, and 1 in the bones and pancreas(%5).
Conclusion:68Ga-DOTA-peptide PET/CT could find the primary or metastasis sites of NETs with good quality images. In general, this modality can enhance the management in patients with NETs.

Keywords

References

  1. Kulke MH, Benson AB, Bergsland E, Berlin JD, Blaszkowsky LS, Choti MA, et al. Neuro-endocrine tumors. Journal of the National Comprehensive Cancer Network. 2012; 10(6):724-64.
  2. Clark OH, Ajani JA, Benson AB, Berlin JD, Blaszkowsky LS, Byrd D, et al. Neuro-endocrine tumors. JNCCN Journal of the National Comprehensive Cancer Network. 2009; 7(7):712-47.
  3. Cejas P, Drier Y, Dreijerink KM, Brosens LA, Deshpande V, Epstein CB, et al. Enhancer signatures stratify and predict outcomes of non-functional pancreatic neuroendocrine tumors. Nature medicine. 2019; 25(8):1260-5.
  4. The Chicago consensus on peritoneal surface malignancies: management of neuroendocrine Annals of surgical oncology. 2020:1-5.
  5. Barthet M, Giovannini M, Lesavre N, Boustiere C, Napoleon B, Koch S, et al. Endoscopic ultrasound-guided radio-frequency ablation for pancreatic neuro-endocrine tumors and pancreatic cystic neoplasms: a prospective multicenter study. Endoscopy. 2019; 51(09):836-42.
  6. Lv Y, Han X, Xu X-F, Ji Y, Zhou Y-H, Sun H-C, et al. Risk factors affecting prognosis in metachronous liver metastases from WHO classification G1 and G2 gastroentero-pancreatic neuroendocrine tumors after initial R0 surgical resection. BMC cancer. 2019; 19(1):1-9.
  7. Mazzaferro V, Pulvirenti A, Coppa J. Neuro-endocrine tumors metastatic to the liver: how to select patients for liver trans-plantation? Journal of hepatology. 2007; 47(4):460-6.
  8. De Jong M, Breeman WA, Kwekkeboom DJ, Valkema R, Krenning EP. Tumor imaging and therapy using radiolabeled somato-statin analogues. Accounts of chemical research. 2009; 42(7):873-80.
  9. Krenning E, Kwekkeboom DJ, Bakker Wea, Breeman W, Kooij P, Oei H, et al. Somatostatin receptor scintigraphy with [111 In-DTPA-D-Phe 1]-and [123 I-Tyr 3]-octreotide: the Rotterdam experience with more than 1000 patients. European journal of nuclear medicine. 1993; 20(8):716-31.
  10. Simons ZB, Wangsiricharoen S, Gelwan E, Lilja SB, Santhanam P. SUN-904 Ga68 Dotatate Detects Ectopic ACTH Secreting Atypical Carcinoid Tumor. Journal of the Endocrine Society. 2020; 4(Supplement_1): SUN-904.
  11. Hofman MS, Lau WE, Hicks RJ. Somatostatin receptor imaging with 68Ga DOTATATE PET/CT: clinical utility, normal patterns, pearls, and pitfalls in interpretation. Radiographics. 2015; 35(2):500-16.
  12. Guenter R, Aweda T, Matos DMC, Jang S, Whitt J, Cheng Y-Q, et al. Overexpression of somatostatin receptor type 2 in neuro-endocrine tumors for improved Ga68-DOTATATE imaging and treatment. Surgery. 2020; 167(1):189-96.
  13. Ćwikła JB, Bodei L, Kolasinska-Ćwikła A, Sankowski A, Modlin IM, Kidd M. Circulating transcript analysis (NETest) in GEP-NETs treated with somatostatin analogs defines The Journal of Clinical Endocrinology & Metabolism. 2015; 100 (11):E1437-E45.
  14. Melis M, Krenning EP, Bernard BF, Barone R, Visser TJ, de Jong M. Localisation and mechanism of renal retention of radio-labelled somatostatin analogues. European journal of nuclear medicine and molecular imaging. 2005; 32(10):1136-43.
  15. Li WP, Lewis JS, Kim J, Bugaj JE, Johnson MA, Erion JL, et al. DOTA− d-Tyr1-Octreotate: A Somatostatin Analogue for Labeling with Metal and Halogen Radionuclides for Cancer Imaging and Therapy. Bioconjugate chemistry. 2002; 13(4):721-8.
  16. Van Essen M, Krenning EP, De Jong M, Valkema R, Kwekkeboom DJ. Peptide receptor radionuclide therapy with radiolabelled somatostatin analogues in patients with somatostatin receptor positive tumours. Acta Oncologica. 2007; 46(6):723-34.
  17. Bombardieri E, Maccauro M, de Deckere E, Savelli G, Chiti A. Nuclear medicine imaging of neuroendocrine tumours. Annals of Oncology. 2001; 12:S51-S61.
  18. Bozkurt MF, Virgolini I, Balogova S, Beheshti M, Rubello D, Decristoforo C, et al. Guideline for PET/CT imaging of neuroendocrine neoplasms with (68)Ga-DOTA-conjugated somatostatin receptor targeting peptides and (18)F-DOPA. Eur J Nucl Med Mol Imaging. 2017; 44(9):1588-601.
  19. Gustafsson BI, Kidd M, Modlin IM. Neuro-endocrine tumors of the diffuse neuro-endocrine system. Current opinion in oncology. 2008; 20(1):1-12.
  20. Modlin IM, Oberg K, Chung DC, Jensen RT, de Herder WW, Thakker RV, et al. Gastro-enteropancreatic neuroendocrine tumours. The lancet oncology. 2008; 9(1): 61-72.
  21. Crown A, Rocha FG, Raghu P, Lin B, Funk G, Alseidi A, et al. Impact of initial imaging with gallium‐68 dotatate PET/CT on diagnosis and management of patients with neuroendocrine tumors. Journal of Surgical Oncology. 2020; 121(3):480-5.
  22. Begum N, Maasberg S, Plöckinger U, Anlauf M, Rinke A, Pöpperl G, et al. Neuroendocrine tumours of the GI tract--data from the German NET Registry. Zentralblatt furChirurgie. 2012; 139(3):276-83.
  23. Hofman MS, Kong G, Neels OC, Eu P, Hong E, Hicks RJ. High management impact of Ga-68 DOTATATE (GaTate) PET/CT for imaging neuroendocrine and other somatostatin expressing tumours. J Med Imaging Radiat Oncol. 2012; 56(1):40-7.
  24. Özkan ZG, Kuyumcu S, Balköse D, Ozkan B, Aksakal N, Yılmaz E, et al. The value of somatostatin receptor imaging with In-111 Octreotide and/or Ga-68 DOTATATE in localizing Ectopic ACTH producing tumors.Mol Imaging Radionucl Ther. 2013; 22(2): 49-55.
  25. Frilling A, Sotiropoulos GC, Radtke A, Malago M, Bockisch A, Kuehl H, et al. The impact of 68Ga-DOTATOC positron emission tomography/ computed tomography on the multimodal management of patients with neuro-endocrine tumors. Annals of surgery. 2010; 252(5):850-6.
  26. Yang J, Kan Y, Ge BH, Yuan L, Li C, Zhao W. Diagnostic role of Gallium-68 DOTATOC and Gallium-68 DOTATATE PET in patients with neuroendocrine tumors: a meta-analysis. Acta Radiol. 2014; 55(4):389-98.
  27. Delpassand ES, Ranganathan D, Wagh N, Shafie A, Gaber A, Abbasi A, et al. 64Cu-DOTATATE PET/CT for Imaging Patients with Known or Suspected Somatostatin Receptor–Positive Neuroendocrine Tumors: Results of the First US Prospective, Reader-Masked Clinical Trial. Journal of Nuclear Medicine. 2020; 61(6):890-6.
Asia Oceania Journal of Nuclear Medicine and Biology
Volume 10, Issue 1
January 2022
Pages 14-19

Files

Share

How to cite

Statistics