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Functional imaging of neuroendocrine tumors with combined PET/CT using 68Ga-DOTATATE (DOTA-DPhe1,Tyr3-octreotate) and 18F-FDG

Kayani, I.; Bomanji, J.B.; Groves, A.; Conway, G.; Gacinovic, S.; Win, T.; Dickson, J.; Caplin, M.; Ell, P.J.

Cancer 112(11): 2447-2455

2008


ISSN/ISBN: 1097-0142
PMID: 18383518
DOI: 10.1002/cncr.23469
Accession: 053325831

The aim was to assess the relevant distribution of the novel PET tracer (68)Ga-DOTATATE in neuroendocrine tumors (NETs) with combined positron emission tomography / computed tomography (PET/CT) and compare its performance with that of (18)F-FDG PET/CT. The imaging findings with (68)Ga-DOTATATE and (18)F-FDG on 38 consecutive patients with a diagnosis of primary or recurrent NET were compared and correlated with tumor grade on histology based on ki67 and mitotic index. The sensitivity of (68)Ga-DOTATATE PET/CT was 82% (31 of 38) and that of (18)F-FDG PET/CT was 66% (25 of 38). The sensitivity of combined (68)Ga-DOTATATE and (18)F-FDG PET/CT was 92% (35 of 38). There was greater uptake of (68)Ga-DOTATATE than (18)F-FDG in low-grade NET (median SUV 29 vs 2.9, P < .001). In high-grade NET there was higher uptake of (18)F-FDG over (68)Ga-DOTATATE (median SUV 11.7 vs 4.4, P = .03). There was a significant correlation with predominant tumor uptake of (68)Ga-DOTATATE or (18)F-FDG and tumor grade on histology (P < .0001). (68)Ga-DOTATATE PET/CT is a useful novel imaging modality for NETs and is superior to (18)F-FDG for imaging well-differentiated NET. Functional imaging with both (68)Ga-DOTATATE and (18)F-FDG has potential for a more comprehensive tumor assessment in intermediate- and high-grade tumors.

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