Haug Alexander, Auernhammer Christoph J, Wängler Björn, Tiling Reinhold, Schmidt Gerwin, Göke Burkhard, Bartenstein Peter, Pöpperl Gabriele
Department of Nuclear Medicine, Ludwig Maximilians University, Munich, Germany.
Eur J Nucl Med Mol Imaging. 2009 May;36(5):765-70. doi: 10.1007/s00259-008-1030-8. Epub 2009 Jan 10.
To compare the diagnostic impact of (68)Ga-DOTA-TATE and (18)F-DOPA PET in the diagnosis of well-differentiated metastatic neuroendocrine tumours (NET).
PET/CT using both (68)Ga-DOTA-TATE and (18)F-DOPA was performed in 25 patients with histologically proven metastatic NET (nine gut, five pancreas, six lung, one paranasal sinus, four with unknown primary). Analyses of PET examinations were patient-based (pathological uptake: yes/no), and based on tumour regions (primary tumour if present and metastases of liver, lung, bones and lymph nodes). The results were compared with the results of contrast enhanced CT, and with plasma serotonin levels, which were available in 24 of the 25 patients.
Patient-based sensitivities were 96% for (68)Ga-DOTA-TATE PET and 56% for (18)F-DOPA PET. (68)Ga-DOTA-TATE PET delineated metastases in 54 of 55 positive metastatic tumour regions in contrast to 29 of 55 delineated by (18)F-DOPA PET. Overall, (68)Ga-DOTA-TATE was superior to (18)F-DOPA in 13 patients (two patients showed fewer positive tumour regions with (18)F-DOPA PET). The results were comparable in 12 patients. In 13 of 24 patients, plasma serotonin levels were elevated, and 11 of these 13 patients showed pathological uptake of (18)F-DOPA. Of the 11 patients with normal levels of serotonin, 3 also showed positive (18)F-DOPA uptake. In patients positive for (18)F-DOPA uptake the maximum tumour SUVs were correlated with the levels of serotonin (r=0.66, p=0.01).
In this study (68)Ga-DOTA-TATE PET proved clearly superior to (18)F-DOPA PET for detection and staging of NET. (18)F-DOPA uptake tended to be increased in those patients with elevated plasma serotonin. We conclude that (18)F-DOPA PET should be employed in patients with NET with negative (68)Ga-DOTA-TATE PET and elevated plasma serotonin.
比较（68）Ga-DOTA-TATE和（18）F-DOPA PET对高分化转移性神经内分泌肿瘤（NET）的诊断价值。
对25例经组织学证实为转移性NET的患者（9例肠道、5例胰腺、6例肺、1例鼻旁窦、4例原发灶不明）进行了（68）Ga-DOTA-TATE和（18）F-DOPA的PET/CT检查。PET检查分析基于患者（病理性摄取：是/否），并基于肿瘤区域（如有原发肿瘤以及肝、肺、骨和淋巴结转移灶）。将结果与增强CT结果以及25例患者中24例可获得的血浆5-羟色胺水平进行比较。
基于患者的敏感性，（68）Ga-DOTA-TATE PET为96%，（18）F-DOPA PET为56%。（68）Ga-DOTA-TATE PET在55个阳性转移性肿瘤区域中的54个勾勒出转移灶，而（18）F-DOPA PET仅勾勒出55个中的29个。总体而言，13例患者中（68）Ga-DOTA-TATE优于（18）F-DOPA（2例患者（18）F-DOPA PET显示的阳性肿瘤区域较少）。12例患者结果相当。24例患者中有13例血浆5-羟色胺水平升高，这13例患者中有11例显示（18）F-DOPA病理性摄取。11例5-羟色胺水平正常的患者中，3例也显示（18）F-DOPA摄取阳性。在（18）F-DOPA摄取阳性的患者中，最大肿瘤SUV与5-羟色胺水平相关（r=0.66，p=0.01）。
在本研究中，（68）Ga-DOTA-TATE PET在NET的检测和分期方面明显优于（18）F-DOPA PET。血浆5-羟色胺升高的患者（（68）Ga-DOTA-TATE PET）摄取（18）F-DOPA往往增加。我们得出结论，对于（68）Ga-DOTA-TATE PET阴性且血浆5-羟色胺升高的NET患者，应采用（18）F-DOPA PET检查。
