From the *Department of Nuclear Medicine, Medical University of Warsaw, Warsaw, Poland; and †Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
Clin Nucl Med. 2017 Dec;42(12):905-911. doi: 10.1097/RLU.0000000000001877.
The presence of somatostatin receptors in neuroendocrine tumors allows visualization with radiolabeled somatostatin analogs in vivo. The aim of this prospective study was to compare somatostatin receptor imaging using Tc-HYNICTOC with Ga-DOTATATE (DOTA-DPhe1,Tyr3-octreotate) with respect to sensitivity, specificity, and impact upon clinical decision making.
Sixty-eight patients (30 men, 38 women; aged 56.4 ± 13.5 years) with disseminated, histologically proven neuroendocrine tumor were enrolled. All patients with previous Tc-HYNICTOC (Tektrotyd; POLATOM, Otwock, Poland) underwent Ga-DOTATATE PET/CT. Both examinations were compared on a per-patient and per-lesion basis.
The sensitivity, specificity, positive and negative predictive values, and accuracy of Ga-DOTATATE and Tc-HYNICTOC were 100% versus 82%, 85% versus 69%, 97% versus 92%, 100% versus 47%, and 97% versus 79%, respectively.Concordant results were observed in 58 patients (49/68 positive on both Ga-DOTATATE and Tc-HYNICTOC and 9/68 negative in both examinations). Ten of 68 patients had Ga-DOTATATE-positive, Tc-HYNICTOC-negative studies. Two hundred eighteen lesions were detected using Tc-HYNICTOC, compared with 546 lesions using Ga-DOTATATE (P < 0.0001). Ga-DOTATATE detected a higher number of lesions in bone and lymph nodes, liver, intestine, and pancreas and had a higher sensitivity for subcentimeter abnormalities than Tc-HYNICTOC. Ga-DOTATATE led to management change in 23 (34%) of 68 patients.
Ga-DOTATATE has a higher sensitivity than Tc-HYNICTOC for the detection of neuroendocrine tumors. Ga-DOTATATE proved superior to Tc-HYNICTOC in detecting subcentimeter skeletal, lymph node, and liver metastases. Ga-DOTATATE PET/CT changed clinical decision making in one third of patients.
生长抑素受体存在于神经内分泌肿瘤中，使得可以使用放射性标记的生长抑素类似物进行体内可视化。本前瞻性研究的目的是比较 Tc-HYNICTOC 和 Ga-DOTATATE（DOTA-DPhe1，Tyr3-octreotate）的生长抑素受体成像，以评估其敏感性、特异性和对临床决策的影响。
纳入 68 例（30 名男性，38 名女性；年龄 56.4 ± 13.5 岁）有播散性、组织学证实的神经内分泌肿瘤的患者。所有之前接受过 Tc-HYNICTOC（Tektrotyd；POLATOM，Otwock，波兰）检查的患者均进行 Ga-DOTATATE PET/CT 检查。基于患者和病变对两种检查进行比较。
Ga-DOTATATE 和 Tc-HYNICTOC 的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 100%比 82%，85%比 69%，97%比 92%，100%比 47%和 97%比 79%。在 58 例患者（54 例 Ga-DOTATATE 和 Tc-HYNICTOC 均阳性，9 例均阴性）中观察到一致的结果。10 例患者 Ga-DOTATATE 阳性而 Tc-HYNICTOC 阴性。与 Tc-HYNICTOC 相比，Ga-DOTATATE 检测到更多的病变，分别为 218 个和 546 个（P<0.0001）。Ga-DOTATATE 在骨和淋巴结、肝脏、肠道和胰腺中检测到更多的病变，并且对亚厘米大小的异常具有更高的敏感性。与 Tc-HYNICTOC 相比，Ga-DOTATATE 使 23（34%）例患者的管理发生改变。
Ga-DOTATATE 对神经内分泌肿瘤的检测敏感性高于 Tc-HYNICTOC。Ga-DOTATATE 在检测亚厘米大小的骨骼、淋巴结和肝转移方面优于 Tc-HYNICTOC。Ga-DOTATATE PET/CT 改变了三分之一患者的临床决策。
