Tabacchi Elena, Fortunati Emilia, Argalia Giulia, Zanoni Lucia, Calabrò Diletta, Telo Silvi, Campana Davide, Lamberti Giuseppe, Ricci Claudio, Casadei Riccardo, Fanti Stefano, Ambrosini Valentina
Nuclear Medicine, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Nuclear Medicine, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy.
Cancers (Basel). 2022 Jul 21;14(14):3541. doi: 10.3390/cancers14143541.
[68Ga]Ga-DOTA-peptide uptake in the pancreatic head/uncinate process (UP) is a frequent PET/CT finding. Although mostly physiologic, it can represent a pitfall in PET/CT reading, especially when focal. An increased frequency of UP uptake has been reported in patients (pts) affected by diabetes mellitus (DM). The aim of the study is to describe the frequency of [68Ga]Ga-DOTANOC UP uptake to evaluate its variations over time and its possible correlation with DM.
In September 2017, a monocentric prospective observational electronic archive was initiated at our center to collect clinical and imaging data of pts undergoing [68Ga]Ga-DOTANOC PET/CT. Among the pts enrolled in the first 6 months (Sept 2017 to Feb 2018), those presenting [68Ga]Ga-DOTANOC PET/CT uptake at UP level were included. Pts with UP lesions already documented on CT/MRI or those that underwent surgical excision of UP before PET/CT were excluded from the analysis. [68Ga]Ga-DOTANOC UP uptake was classified as diffuse or focal and compared with the pattern observed in previous PET/CT scans performed at our center. An increased frequency of UP uptake was also correlated with the presence of DM.
In the first 6 months, 253 pts were enrolled in the archive and 172 out of them were included in the analysis. UP increased uptake was frequently observed (77/172, 44.8%) and was mostly diffuse (62/77). In 75/172 pts (43.6%), previous [68Ga]Ga-DOTANOC PET/CT scans were available (overall 268 scans; number of previous PET per pt range: 1-20) and were retrospectively reviewed. Despite the fact that, in most pts, the uptake pattern was stable over time (54/75 pts, 72%), it changed in approximately one third of cases (21/75, 28%). Among DM pts (29/172), only 10/29 (34.4%) presented increased UP uptake.
UP [68Ga]Ga-DOTANOC uptake is a frequent non-malignant finding (slightly higher than previously reported), mostly presenting with a diffuse pattern. However, contrary to previous reports, our data show that the pattern of uptake may vary over time in approximately one third of the cases and it is not more frequently observed in pts with DM.
胰腺头部/钩突部（UP）出现[68Ga]镓-多柔比星肽摄取是PET/CT检查中常见的表现。虽然大多属于生理性摄取，但在PET/CT读片时可能会造成误诊，尤其是局灶性摄取时。据报道，糖尿病（DM）患者中UP摄取增加的频率较高。本研究旨在描述[68Ga]镓-多柔比星肽在UP的摄取频率，评估其随时间的变化以及与DM的可能相关性。
2017年9月，我们中心启动了一项单中心前瞻性观察性电子存档项目，以收集接受[68Ga]镓-多柔比星肽PET/CT检查患者的临床和影像数据。在最初6个月（2017年9月至2018年2月）入组的患者中，纳入了在UP水平出现[68Ga]镓-多柔比星肽PET/CT摄取的患者。CT/MRI已记录有UP病变或在PET/CT检查前已接受UP手术切除的患者被排除在分析之外。[68Ga]镓-多柔比星肽在UP的摄取分为弥漫性或局灶性，并与我们中心之前进行的PET/CT扫描中观察到的模式进行比较。UP摄取增加的频率也与DM的存在相关。
在最初6个月中，253例患者被纳入存档，其中172例被纳入分析。经常观察到UP摄取增加（77/172，44.8%），且大多为弥漫性（62/77）。在75/172例患者（43.6%）中，有之前的[68Ga]镓-多柔比星肽PET/CT扫描结果（总共268次扫描；每位患者之前的PET扫描次数范围：1 - 20次），并进行了回顾性分析。尽管在大多数患者中，摄取模式随时间稳定（54/75例患者，72%），但在约三分之一的病例中发生了变化（21/75，28%）。在DM患者（29/172）中，只有10/29（34.4%）出现UP摄取增加。
UP出现[68Ga]镓-多柔比星肽摄取是一种常见的非恶性表现（略高于先前报道），大多呈现弥漫性模式。然而，与先前报道相反，我们的数据显示，在约三分之一的病例中，摄取模式可能随时间变化，且在DM患者中并不更常观察到。
