Ambrosini Valentina, Tomassetti Paola, Castellucci Paolo, Campana Davide, Montini Giancarlo, Rubello Domenico, Nanni Cristina, Rizzello Anna, Franchi Roberto, Fanti Stefano
Unità Operativa di Medicina Nucleare, Azienda Ospedaliero Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Padiglione 30, Via Massarenti 9, 40138, Bologna, Italy.
Eur J Nucl Med Mol Imaging. 2008 Aug;35(8):1431-8. doi: 10.1007/s00259-008-0769-2. Epub 2008 Apr 17.
(18)F-FDG positron emission tomography (PET) value for the assessment of neuro-endocrine tumours (NET) is limited. Preliminary studies indicate that (18)F-DOPA and (68)Ga-DOTA-NOC are more accurate for disease assessment and (68)Ga-DOTA peptides provide additional data on receptor status that are crucial for targeted radionuclide therapy. At present, there are no comparative studies investigating their role in NET.
The aim of this study was to compare (68)Ga-DOTA-NOC and (18)F-DOPA for the evaluation of gastro-entero-pancreatic and lung neuro-endocrine tumours.
Thirteen patients with biopsy-proven NET (gastro-entero-pancreatic or pulmonary) were prospectively enrolled and scheduled for (18)F-DOPA and (68)Ga-DOTA-NOC PET. PET results obtained with both tracers were compared with each other, with other conventional diagnostic procedures (CT, ultrasound) and with follow-up (clinical, imaging).
The most common primary tumour site was the pancreas (8/13) followed by the ileum (2/13), the lung (2/13) and the duodenum (1/13). The carcinoma was well differentiated in 10/13 and poorly differentiated in 3/13 cases. (68)Ga-DOTA-NOC PET was positive, showing at least one lesion, in 13/13 cases while (18)F-DOPA PET was positive in 9/13. On a lesions basis, (68)Ga-DOTA-NOC identified more lesions than (18)F-DOPA (71 vs 45), especially at liver, lung and lymph node level. (68)Ga-DOTA-NOC correctly identified the primary site in six of eight non-operated cases (in five cases, the primary was surgically removed before PET), while (18)F-DOPA identified the primary only in two of eight cases.
Although the patients studied are few and heterogeneous, our data show that (68)Ga-DOTA-NOC is accurate for the detection of gastro-entero-pancreatic and lung neuro-endocrine tumours in either the primary or metastatic site and that it offers several advantages over (18)F-DOPA.
（18）F - FDG正电子发射断层扫描（PET）在评估神经内分泌肿瘤（NET）方面的价值有限。初步研究表明，（18）F - DOPA和（68）Ga - DOTA - NOC在疾病评估方面更准确，并且（68）Ga - DOTA肽能提供有关受体状态的额外数据，这对于靶向放射性核素治疗至关重要。目前，尚无比较研究探讨它们在NET中的作用。
本研究的目的是比较（68）Ga - DOTA - NOC和（18）F - DOPA在评估胃肠胰和肺神经内分泌肿瘤方面的效果。
前瞻性纳入13例经活检证实为NET（胃肠胰或肺）的患者，并安排进行（18）F - DOPA和（68）Ga - DOTA - NOC PET检查。将两种示踪剂获得的PET结果相互比较，与其他传统诊断程序（CT、超声）以及随访结果（临床、影像学）进行比较。
最常见的原发肿瘤部位是胰腺（8/13），其次是回肠（2/13）、肺（2/13）和十二指肠（l/13）。13例中有10例肿瘤分化良好，3例分化差。13/13例患者的（68）Ga - DOTA - NOC PET呈阳性，显示至少一个病灶，而（18）F - DOPA PET在9/13例中呈阳性。基于病灶情况，（68）Ga - DOTA - NOC比（18）F - DOPA识别出更多病灶（71个对45个），尤其是在肝脏、肺和淋巴结层面。在8例未手术的病例中，（68）Ga - DOTA - NOC正确识别出6例的原发部位（5例在PET检查前已手术切除原发灶），而（18）F - DOPA仅在8例中的2例中识别出原发部位。
尽管本研究的患者数量较少且异质性较大，但我们的数据表明，（68）Ga - DOTA - NOC在检测胃肠胰和肺神经内分泌肿瘤的原发或转移部位方面是准确的，并且与（18）F - DOPA相比具有多个优势。
