Putzer D, Gabriel M, Kendler D, Henninger B, Knoflach M, Kroiss A, Vonguggenberg E, Warwitz B, Virgolini I J
Department of Nuclear Medicine, Innsbruck Medical University, Innsbruck, Austria.
Q J Nucl Med Mol Imaging. 2010 Feb;54(1):68-75.
(68)Ga-DOTA-Tyr3-octreotide positron emission tomography ((68)Ga-DOTA-TOC PET) and (18)F-fluoro-L-dihydroxyphenylalanine PET ((18)F-DOPA PET) are emerging modalities for imaging of neuroendocrine tumors. This study reports our initial experiences with these two PET modalities on initial diagnosis, staging and restaging in NET patients.
Fifteen patients with NET underwent both (68)Ga-DOTA-TOC and (18)F-DOPA PET as well as computed tomography (CT). Image findings were compared on a patient-basis (pathological uptake: yes/no) as well as on a lesion-basis. Contrast-enhanced CT and histological follow-up served as gold standard. Furthermore, imaging results were matched with tumor marker levels and quantitative tracer uptake by the tumor lesions.
When comparing (68)Ga-DOTA-TOC and (18)F-DOPA PET, each modality showed a sensitivity of 64% and a specificity of 100% on a patient-based analysis. (68)Ga-DOTA-TOC PET and (18)F-DOPA PET showed equal findings in 7 out of 15 patients and disagreement in 8 patients. (68)Ga-DOTA-TOC revealed more metastases than (18)F-DOPA PET in 6 patients, while (18)F-DOPA PET detected more metastases than (68)Ga-DOTA-TOC in 4 patients. By (68)Ga-DOTA-TOC PET, 208 malignant lesions were detected, while by (18)F-DOPA only 86 lesions were found, and in CT 124, respectively.
(68)Ga-DOTA-TOC and (18)F-DOPA PET are useful tools in the detection and staging of NET lesions. Our initial results allow the conclusion that (68)Ga-DOTA-TOC PET may have a stronger clinical impact in NET patients, as it does not only offer diagnostic information, but is decisive for the further treatment management, i. e. PRRT, as well.
（68）镓 - DOTA - 酪胺酸3 - 奥曲肽正电子发射断层扫描（（68）Ga - DOTA - TOC PET）和（18）氟 - L - 二羟基苯丙氨酸PET（（18）F - DOPA PET）是用于神经内分泌肿瘤成像的新兴模态。本研究报告了我们在NET患者的初始诊断、分期和再分期中使用这两种PET模态的初步经验。
15例NET患者接受了（68）Ga - DOTA - TOC和（18）F - DOPA PET以及计算机断层扫描（CT）检查。在个体患者基础上（病理性摄取：是/否）以及在病灶基础上比较图像结果。增强CT和组织学随访作为金标准。此外，将成像结果与肿瘤标志物水平以及肿瘤病灶的示踪剂摄取定量进行匹配。
在基于个体患者的分析中，比较（68）Ga - DOTA - TOC和（18）F - DOPA PET时，每种模态的敏感性均为64%，特异性均为100%。在15例患者中，（68）Ga - DOTA - TOC PET和（18）F - DOPA PET在7例患者中显示出相同的结果，在8例患者中结果不同。6例患者中，（68）Ga - DOTA - TOC显示的转移灶比（18）F - DOPA PET更多，而4例患者中，（18）F - DOPA PET检测到的转移灶比（68）Ga - DOTA - TOC更多。通过（68）Ga - DOTA - TOC PET检测到208个恶性病灶，而通过（18）F - DOPA仅发现86个病灶，CT分别检测到124个病灶。
（68）Ga - DOTA - TOC和（18）F - DOPA PET是检测NET病灶和进行分期的有用工具。我们的初步结果表明，（68）Ga - DOTA - TOC PET可能对NET患者具有更强的临床影响，因为它不仅提供诊断信息，而且对进一步的治疗管理（即PRRT）也具有决定性作用。
