Krebs Simone, O'Donoghue Joseph A, Biegel Evan, Beattie Bradley J, Reidy Diane, Lyashchenko Serge K, Lewis Jason S, Bodei Lisa, Weber Wolfgang A, Pandit-Taskar Neeta
Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Eur J Nucl Med Mol Imaging. 2020 Dec;47(13):3047-3057. doi: 10.1007/s00259-020-04832-9. Epub 2020 May 6.
Paired imaging/therapy with radiolabeled somatostatin receptor (SSTR) antagonists is a novel approach in neuroendocrine tumors (NETs). The aim of this study was to compare tumor uptake of Ga-DOTA-JR11 and Lu-satoreotide tetraxetan (Lu-DOTA-JR11) in patients with NETs.
As part of a prospective clinical trial, 20 patients with metastatic NETs underwent Ga-DOTA-JR11 PET/CT and serial imaging with Lu-satoreotide tetraxetan. PET/CT and SPECT/CT parameters for lesion uptake and absorbed dose of Lu-satoreotide tetraxetan in lesions were compared using linear regression analysis and Pearson correlation.
A total of 95 lesions were analyzed on Ga-DOTA-JR11 PET/CT and Lu-satoreotide tetraxetan SPECT/CT. SUVs and tumor-to-normal-tissue ratios on PET/CT and SPECT/CT were significantly correlated (p < 0.01), but the degree of correlation was modest with Pearson correlation coefficients ranging from 0.3 to 0.7. Variation in intrapatient lesional correlation was observed. Nevertheless, in all patients, the lesion SUVpeak uptake ratio for Lu-satoreotide tetraxetan vs. Ga-DOTA-JR11 was high; even in those with low uptake on Ga-DOTA-JR11 PET/CT (SUVpeak ≤ 10), a ratio of 8.0 ± 5.2 was noted. Correlation of SUVpeak of Ga-DOTA-JR11 with projected Lu-satoreotide tetratexan-absorbed dose (n = 42) was modest (r = 0.5, p < 0.01), while excellent correlation of SUVpeak of Lu-satoreotide tetraxetan with projected Lu-satoreotide tetraxetan-absorbed dose was noted (r = 0.9, p < 0.0001).
Our study shows that Ga-DOTA-JR11 PET can be used for patient selection and PRRT and that low tumor uptake on PET should not preclude patients from treatment with Lu-satoreotide tetraxetan. The ability to use single time-point SPECT/CT for absorbed dose calculations could facilitate dosimetry regimens, save costs, and improve patient convenience.
使用放射性标记的生长抑素受体（SSTR）拮抗剂进行配对成像/治疗是神经内分泌肿瘤（NETs）的一种新方法。本研究的目的是比较NETs患者中镓 - DOTA - JR11和镥 - 司他瑞肽四醋铵（镥 - DOTA - JR11）的肿瘤摄取情况。
作为一项前瞻性临床试验的一部分，20例转移性NETs患者接受了镓 - DOTA - JR11 PET/CT检查以及镥 - 司他瑞肽四醋铵的系列成像检查。使用线性回归分析和Pearson相关性分析比较PET/CT和SPECT/CT的病变摄取参数以及镥 - 司他瑞肽四醋铵在病变中的吸收剂量。
对镓 - DOTA - JR11 PET/CT和镥 - 司他瑞肽四醋铵SPECT/CT上的总共95个病变进行了分析。PET/CT和SPECT/CT上的SUV值和肿瘤与正常组织比值显著相关（p < 0.01），但相关性程度中等，Pearson相关系数范围为0.3至0.7。观察到患者内病变相关性存在差异。然而，在所有患者中，镥 - 司他瑞肽四醋铵与镓 - DOTA - JR11的病变SUV峰值摄取比值都很高；即使在镓 - DOTA - JR11 PET/CT上摄取较低的患者（SUV峰值≤10）中，该比值也为8.0±5.2。镓 - DOTA - JR11的SUV峰值与预计的镥 - 司他瑞肽四醋铵吸收剂量（n = 42）的相关性中等（r = 0.5，p < 0.01），而镥 - 司他瑞肽四醋铵的SUV峰值与预计的镥 - 司他瑞肽四醋铵吸收剂量具有极好的相关性（r = 0.9，p < 0.0001）。
我们的研究表明，镓 - DOTA - JR11 PET可用于患者选择和肽受体放射性核素治疗（PRRT），并且PET上肿瘤摄取较低不应排除患者接受镥 - 司他瑞肽四醋铵治疗。使用单时间点SPECT/CT进行吸收剂量计算的能力可以促进剂量测定方案，节省成本，并提高患者的便利性。
