Neuroendocrine Tumour Unit, Royal Free Hospital, London, UK.
J Nucl Med. 2010 Jun;51(6):875-82. doi: 10.2967/jnumed.109.066134. Epub 2010 May 19.
(111)In-diethylenetriaminepentaacetic acid (DTPA)-octreotide scintigraphy is currently the nuclear medicine imaging modality of choice for identifying neuroendocrine tumors. However, there are cohorts of patients in whom scintigraphy findings are negative or equivocal. We evaluated the role of (68)Ga-DOTATATE PET in a selected group of patients with negative or weakly positive findings on (111)In-DTPA-octreotide scintigraphy to determine whether (68)Ga-DOTATATE PET is able to detect additional disease and, if so, whether patient management is altered.
Fifty-one patients with a histologically confirmed diagnosis of neuroendocrine tumors were included. Of the 51 patients, 35 who were negative and 16 equivocal for uptake on (111)In-DTPA-octreotide scintigraphy underwent (68)Ga-DOTATATE PET. Findings were compared using a region-by-region analysis. All findings were verified with CT or MRI. After (68)Ga-DOTATATE PET, all cases were reviewed to determine whether the (68)Ga-DOTATATE PET findings resulted in any alteration in management, in terms of suitability for peptide receptor therapy, somatostatin analogs, and surgery.
Of the 51 patients, 47 had evidence of disease on cross-sectional imaging or biochemically. (68)Ga-DOTATATE PET was positive in 41 of these 47 patients (87.2%). No false-positive lesions were identified. (68)Ga-DOTATATE PET detected 168 of the 226 lesions (74.3%) that were identified with cross-sectional imaging. (68)Ga-DOTATATE PET identified significantly more lesions than (111)In-DTPA-octreotide scintigraphy (P < 0.001). There was no correlation between (68)Ga-DOTATATE uptake and histologic grade of neuroendocrine tumors. (68)Ga-DOTATATE imaging changed management in 36 patients (70.6%), who were subsequently deemed suitable for peptide receptor-targeted therapy.
In patients with negative or equivocal (111)In-DTPA-octreotide findings, (68)Ga-DOTATATE PET identifies additional lesions and may alter management in most cases.
（111）二乙烯三胺五乙酸（DTPA）-奥曲肽闪烁显像术目前是识别神经内分泌肿瘤的核医学成像方式。然而，有一群患者的闪烁显像结果为阴性或不确定。我们评估了（68）Ga-DOTATATE PET 在一组接受阴性或弱阳性（111）In-DTPA-奥曲肽闪烁显像检查的患者中的作用，以确定（68）Ga-DOTATATE PET 是否能够检测到额外的疾病，如果可以，患者的管理是否会发生变化。
纳入 51 例经组织学证实的神经内分泌肿瘤患者。在 51 例患者中，35 例（111）In-DTPA-奥曲肽闪烁显像摄取阴性，16 例摄取不确定，进行了（68）Ga-DOTATATE PET。采用区域分析比较结果。所有发现均通过 CT 或 MRI 验证。在（68）Ga-DOTATATE PET 后，对所有病例进行了回顾，以确定（68）Ga-DOTATATE PET 的结果是否会导致肽受体治疗、生长抑素类似物和手术的任何管理改变。
在 51 例患者中，有 47 例在横断面成像或生化检查中有疾病证据。在这 47 例患者中，有 41 例（87.2%）（68）Ga-DOTATATE PET 阳性。未发现假阳性病变。（68）Ga-DOTATATE PET 检测到 226 个病变中的 168 个（74.3%），这些病变通过横断面成像检测到。（68）Ga-DOTATATE PET 比（111）In-DTPA-奥曲肽闪烁显像术（P < 0.001）检测到更多的病变。（68）Ga-DOTATATE 摄取与神经内分泌肿瘤的组织学分级之间没有相关性。（68）Ga-DOTATATE 成像改变了 36 例患者（70.6%）的治疗管理，随后认为这些患者适合肽受体靶向治疗。
在（111）In-DTPA-奥曲肽结果阴性或不确定的患者中，（68）Ga-DOTATATE PET 可识别出更多病变，并可能改变大多数患者的治疗管理。
