Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital and Institute, Beijing 100142, China.
Contrast Media Mol Imaging. 2022 Nov 7;2022:1750132. doi: 10.1155/2022/1750132. eCollection 2022.
This study aimed to assess the efficacy of dual-tracer [Ga-DOTA-somatostatin receptor analogs (SSAs) and F-fluorodeoxyglucose (FDG)] positron emission tomography/computed tomography (PET/CT) imaging for detecting bone metastases (BMs) in patients with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs).
We retrospectively enrolled 74 GEP-NEN patients with BMs from two centers, who underwent dual-tracer PET/CT from January 2014 to March 2021. We compared and analyzed effectiveness of the dual PET/CT imaging techniques on the BMs, based on F-FDG and Ga-DOTA-SSAs. Specifically, we analyzed the imaging results using tests for classification variables, paired-sample tests for number of BMs, Wilcoxon's signed rank test for number of lesions, and the Kruskal-Wallis test for standard uptake value (SUV) ratio comparison. The correlation of dual-tracer SUVmax with Ki-67 index was analyzed by Spearman's correlation coefficient.
The detection efficiencies of dual-tracer PET/CT imaging in patients with different pathologies showed discordant for detecting liver metastases and BMs in group neuroendocrine tumor (NET) G3, Ga-DOTA-SSAs was better at detecting BMs for NET G3 (=0.049 for SUV and =0.026 for the number of metastatic lesions). In addition, statistical significance was found among osteogenesis group, osteolysis group, and the no-change group (for bone SUV value detected by F-FDG and Ki-67 index, osteogenesis group < osteolysis group; for bone SUV detected by Ga-DOTA-SSAs, osteogenesis group > the no-change group). What is more, liver and bone SUVmax and Ki-67 index were positively correlated in F-FDG imaging ( < 0.001 for liver; =0.002 for bone), and negatively correlated in Ga-DOTA-SSAs imaging ( < 0.001 for liver; =0.039 for bone).
Ga-DOTA-SSAs was superior to F-FDG for detecting BMs in NET G1/G2 (well and moderately differentiated NETs), as well as in NET G3 (poorly differentiated NETs). Relatively good differentiation was observed in the osteogenesis group. In addition, dual-tracer PET/CT imaging results were observably correlated with tumor differentiation.
本研究旨在评估双示踪剂[镓-DOTA-生长抑素受体类似物（SSA）和 F-氟脱氧葡萄糖（FDG）]正电子发射断层扫描/计算机断层扫描（PET/CT）成像在检测胃肠胰神经内分泌肿瘤（GEP-NEN）患者骨转移（BM）中的疗效。
我们回顾性纳入了 2014 年 1 月至 2021 年 3 月期间在两个中心接受双示踪剂 PET/CT 的 74 例 GEP-NEN 伴 BM 患者。我们基于 F-FDG 和 Ga-DOTA-SSA 比较和分析了双 PET/CT 成像技术在 BM 中的有效性。具体来说，我们使用卡方检验对分类变量的影像学结果进行分析，使用配对样本 t 检验对 BM 数量进行分析，使用 Wilcoxon 符号秩检验对病灶数量进行分析，使用 Kruskal-Wallis 检验对标准摄取值（SUV）比值进行分析。采用 Spearman 相关系数分析双示踪剂 SUVmax 与 Ki-67 指数的相关性。
不同病理类型患者的双示踪 PET/CT 成像检测效率显示，在神经内分泌肿瘤（NET）G3 组中，Ga-DOTA-SSA 对 BM 的检测优于 F-FDG（SUV 为=0.049，转移病灶数为=0.026）。此外，成骨组、溶骨组和无变化组之间存在统计学差异（F-FDG 检测的骨 SUV 值和 Ki-67 指数，成骨组<溶骨组；Ga-DOTA-SSA 检测的骨 SUV 值，成骨组>无变化组）。此外，在 F-FDG 成像中，肝和骨 SUVmax 与 Ki-67 指数呈正相关（肝：<0.001；骨：=0.002），而在 Ga-DOTA-SSA 成像中呈负相关（肝：<0.001；骨：=0.039）。
与 F-FDG 相比，Ga-DOTA-SSA 更有助于检测 NET G1/G2（分化良好和中度分化的 NET）和 NET G3（分化差的 NET）患者的 BM。成骨组的分化程度相对较好。此外，双示踪剂 PET/CT 成像结果与肿瘤分化程度密切相关。
