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A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the and to the International Research Group of Immunoscintigraphy
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index (SciSearch), Scopus
Impact Factor 2,413
NEUROENDOCRINE UPDATE AND METABOLIC THERAPY
Putzer D. 1, Gabriel M. 1, Kendler D. 1, Henninger B. 2, Knoflach M. 2, Kroiss A. 1, Vonguggenberg E. 1, Warwitz B. 1, Virgolini I. J. 1
1 Department of Nuclear Medicine, Innsbruck Medical University, Innsbruck, Austria;
2 Department of Diagnostic Radiology, Innsbruck Medical University, Innsbruck, Austria
AIM:68Ga-DOTA-Tyr3-octreotide positron emission tomography (68Ga-DOTA-TOC PET) and 18F-fluoro-L-dihydroxyphenylalanine PET (18F-DOPA PET) are emerging modalities for imaging of neuroendocrine tumors. This study reports our initial experiences with these two PET modalities on initial diagnosis, staging and restaging in NET patients.
METHODS: Fifteen patients with NET underwent both 68Ga-DOTA-TOC and 18F-DOPA PET as well as computed tomography (CT). Image findings were compared on a patient-basis (pathological uptake: yes/no) as well as on a lesion-basis. Contrast-enhanced CT and histological follow-up served as gold standard. Furthermore, imaging results were matched with tumor marker levels and quantitative tracer uptake by the tumor lesions.
RESULTS: When comparing 68Ga-DOTA-TOC and 18F-DOPA PET, each modality showed a sensitivity of 64% and a specificity of 100% on a patient-based analysis. 68Ga-DOTA-TOC PET and 18F-DOPA PET showed equal findings in 7 out of 15 patients and disagreement in 8 patients. 68Ga-DOTA-TOC revealed more metastases than 18F-DOPA PET in 6 patients, while 18F-DOPA PET detected more metastases than 68Ga-DOTA-TOC in 4 patients. By 68Ga-DOTA-TOC PET, 208 malignant lesions were detected, while by 18F-DOPA only 86 lesions were found, and in CT 124, respectively.
CONCLUSIONS: 68Ga-DOTA-TOC and 18F-DOPA PET are useful tools in the detection and staging of NET lesions. Our initial results allow the conclusion that 68Ga-DOTA-TOC PET may have a stronger clinical impact in NET patients, as it does not only offer diagnostic information, but is decisive for the further treatment management, i. e. PRRT, as well.