Department of Clinical Medicine, Policlinico S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
J Nucl Med. 2010 Mar;51(3):353-9. doi: 10.2967/jnumed.109.066662. Epub 2010 Feb 11.
Despite the fact that several studies have been published regarding the prognostic factors of neuroendocrine tumors (NETs), there are some cases in which available data are not sufficient to predict disease progression and to define a correct therapeutic approach. To our knowledge, the role of maximum standardized uptake value (SUVmax) as a prognostic factor has never been studied in NET patients. Therefore, we prospectively investigated whether (68)Ga-[1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid]-1-NaI3-octreotide ((68)Ga-DOTANOC) PET SUVmax could be used as an accurate noninvasive marker for disease prognosis.
Forty-seven patients with NETs were studied with (68)Ga-DOTANOC PET. All patients underwent a baseline visit and laboratory and radiologic examinations. Follow-up was performed in all cases.
SUVmax was significantly higher in patients with pancreatic NET and in those with well-differentiated NETs. Moreover, SUVmax was significantly higher in patients with an elevated expression of 2A-somatostatin receptor. During the follow-up, the disease was stable or presented a partial response in 25 patients, and in 19 cases the disease progressed. The patients with stable disease or a partial response had an SUVmax significantly higher than did those in the progressive disease group, with the best cutoff ranging from 17.9 to 19.3. At univariate and multivariate analysis, the significant positive prognostic factors were well-differentiated NET, an SUVmax of 19.3 or more, and a combined treatment with long-acting somatostatin analogs and radiolabeled somatostatin analogs.
We demonstrated, for the first time to our knowledge, that (68)Ga-DOTANOC PET SUVmax correlates with the clinical and pathologic features of NETs and is also an accurate prognostic index.
尽管已经有几项关于神经内分泌肿瘤（NETs）预后因素的研究发表，但在某些情况下，现有数据不足以预测疾病进展并确定正确的治疗方法。据我们所知，最大标准化摄取值（SUVmax）作为预后因素在 NET 患者中从未被研究过。因此，我们前瞻性地研究了（68）Ga-[1,4,7,10-四氮杂环十二烷-1,4,7,10-四乙酸]-1-NaI3-奥曲肽（（68）Ga-DOTANOC）PET SUVmax 是否可作为疾病预后的准确无创标志物。
对 47 例 NET 患者进行（68）Ga-DOTANOC PET 研究。所有患者均进行基线检查、实验室和影像学检查。所有患者均进行随访。
胰腺 NET 患者和分化良好的 NET 患者的 SUVmax 显著更高。此外，2A-生长抑素受体表达较高的患者 SUVmax 也较高。在随访期间，25 例患者疾病稳定或部分缓解，19 例患者疾病进展。疾病稳定或部分缓解的患者 SUVmax 明显高于疾病进展组，最佳截断值范围为 17.9 至 19.3。单因素和多因素分析表明，分化良好的 NET、SUVmax 为 19.3 或更高以及长效生长抑素类似物与放射性标记生长抑素类似物联合治疗是显著的阳性预后因素。
我们首次证明（68）Ga-DOTANOC PET SUVmax 与 NETs 的临床和病理特征相关，并且也是一种准确的预后指标。
