Komek Halil, Ansal Balci Tansel, Can Canan
Department of Nuclear Medicine, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
Department of Nuclear Medicine, Faculty of Medicine, Firat University, Elazig, Turkey.
Asia Ocean J Nucl Med Biol. 2019 Spring;7(2):141-148. doi: 10.22038/AOJNMB.2019.13348.
The aim of this study was to determine metastasis rate in patients with well-differentiated grade1 (G1) and grade 2 (G2) gastroenteropancreatic neuroendocrine tumors (GEP NETs) using the gallium-68 DOTATATE positron emission tomography/computed tomography (Ga-DOTATATE PET/CT). This study was also targeted toward investigating the relationship of maximum standardized uptake value (SUV) with mitotic count, histological grade, and Ki-67 index.
This retrospective study included 38 patients (i.e., 17 males and 21 females) with G1 or G2 GEP NETs who underwent GaDOTATATE PET/CT in Diyarbakir Gazi Yasargil training and research hospital between November 2014 and March 2018. The patients had at least one positive lesion that was approved by two nuclear medicine specialists with a minimum of 10 years of experience.
The median age of the patients was 50 years (age range: 27-80 years), and their mean age was 52±15 years. Out of 38 patients, 1 (2.6%), 2 (5.2%), 2 (5.2%), 3 (7.8%), 10 (28.5%), and 19 (50%) patients had primary hepatic, primary mesenteric, colon, duodenal, gastric, and pancreatic NETs, respectively. In addition, the liver metastasis, local lymph node invasions, distant lymph node metastasis, bone metastasis, peritoneal involvement, and lung metastasis were observed in 42%, 21%, 15.7%, 13%, 7.8%, and 5% of the cases, respectively. The SUV median values of G1 and G2 tumors were 9.45 (range: 4.2-43.6) and 34.9 (range: 4.1-103), respectively (P=0.003). The Ki-67 index showed a negative correlation with the SUV value of the liver metastases and the highest SUV value (P=0.001 and P=0.002, respectively). There was also a negative correlation between mitosis count and the highest SUV value (P=0.011).
Based on the findings, although [Ga]DOTATATE PET/CT is successfully used to diagnose primary GEP NETs and their metastases, the SUV value obtained from DOTATATE PET/CT showed a negative correlation with Ki-67 and mitotic count.
本研究旨在利用镓-68 DOTATATE正电子发射断层扫描/计算机断层扫描（Ga-DOTATATE PET/CT）确定高分化1级（G1）和2级（G2）胃肠胰神经内分泌肿瘤（GEP NETs）患者的转移率。本研究还旨在调查最大标准化摄取值（SUV）与有丝分裂计数、组织学分级和Ki-67指数之间的关系。
这项回顾性研究纳入了2014年11月至2018年3月期间在迪亚巴克尔加齐·亚萨尔吉尔培训和研究医院接受Ga-DOTATATE PET/CT检查的38例G1或G2级GEP NETs患者（即17例男性和21例女性）。患者至少有一个阳性病变，经两名经验至少10年的核医学专家确认。
患者的中位年龄为50岁（年龄范围：27 - 80岁），平均年龄为52±15岁。38例患者中，分别有1例（2.6%）、2例（5.2%）、2例（5.2%）、3例（7.8%）、10例（28.5%）和19例（50%）患者患有原发性肝、原发性肠系膜、结肠、十二指肠、胃和胰腺NETs。此外，分别在42%、21%、15.7%、13%、7.8%和5%的病例中观察到肝转移、局部淋巴结侵犯、远处淋巴结转移、骨转移、腹膜受累和肺转移。G1和G2肿瘤的SUV中位值分别为9.45（范围：4.2 - 43.6）和34.9（范围：4.1 - 103）（P = 0.003）。Ki-67指数与肝转移灶的SUV值和最高SUV值呈负相关（分别为P = 0.001和P = 0.002）。有丝分裂计数与最高SUV值之间也呈负相关（P = 0.011）。
基于这些发现，尽管[Ga]DOTATATE PET/CT成功用于诊断原发性GEP NETs及其转移灶，但从DOTATATE PET/CT获得的SUV值与Ki-67和有丝分裂计数呈负相关。
