68Ga-DOTA-TATE PET/CT can be used to image tumors that express somatostatin including neuro-endocrine tumors (NET) and neuroblastoma. This was a prospective cohort study in adults to assess the utility of 68Ga-DOTA-TATE PET/CT to diagnose and stage Gastro-entero-pancreatic (GEP) NET compared to current approved imaging modalities (111In-pentetreotide SPECT/CT) and/or MRI.
131 patients with biochemically or radiologically suspected or proven GEP NETs underwent imaging: 68Ga-DOTA-TATE PET/CT detected 95% lesions (45% MRI and 31% 111In-pentetreotide SPECT/CT). They compared surgical specimens with imaging techniques and 68Ga-DOTA-TATE PET/CT correctly found primary, Lymph node, and distant metastases in 64% compared to 22%, and 38%, respectively, with other imaging modalities). With additional findings from the imaging, clinical management was changed in a third of cases. In patients with symptoms of carcinoid syndrome, negative serum chromogranin A and urinary 5-HIAA levels, 68Ga-DOTA-TATE PET/CT also detected lesions in 65% of patients when the majority of these were not found on the other imaging techniques.
* 68Ga-DOTA-TATE PET/CT is better than 111In-pentetreotide SPECT/CT and anatomical imaging in detecting and staging Gastro-entero-pancreatic NET and may find lesions even if biochemical markers are absent. This study suggests 68Ga-DOTA-TATE PET/CT should be used in initial management and follow-up of adults with NETs. There are only limited studies in children with NETs and also neuroblastoma ,which expressed Somatostatin receptors, and targeted therapy with 177Lu-DOTA-TATE is being investigated.