Prospective Study of 68Ga-DOTATATE Positron Emission Tomography/Computed Tomography for Detecting Gastro-Entero-Pancreatic Neuroendocrine Tumors and Unknown Primary Sites

Prospective Study of 68Ga-DOTATATE Positron Emission Tomography/Computed Tomography for Detecting Gastro-Entero-Pancreatic Neuroendocrine Tumors and Unknown Primary Sites
Sadowski, S (2016) JCO (Link to Abstract)

 

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.