Megherbi Iness, Hoog Christopher, Perrier Marine, Brixi Hedia, Cadiot Guillaume, Hoeffel-Fornes Christine, Morland David
Médecine Nucléaire, Institut Godinot, Reims, France.
Physique Médicale, Institut Godinot, Reims, France.
EJNMMI Res. 2025 May 6;15(1):53. doi: 10.1186/s13550-025-01250-6.
peptide receptor radionuclide therapy with 177Lu-DOTATATE has become an established second-line treatment for patients with advanced small intestine neuroendocrine tumors (siNET). Treatment efficacy is assessed several months after the end of treatment and is based on RECIST criteria. Post-therapy scintigraphy (PTS) can be performed after each cycle, but its value in early response assessment is debated particularly given the lack of quantification available in clinical routine. New quantification modules are now available, enabling automatic SUV calculation. The main goal of this study is to assess the value of the evolution of SUV between the first (C1) and the second (C2) cycle on quantitative PTS in predicting response to treatment. All patients with siNET referred to our center for treatment with 177Lu-DOTATATE were included. The SUVmax of the lesion with the greatest uptake was measured on PTS SPECT/CT at C1 and C2. ∆SUVmax was calculated. Linear regression between ∆SUVmax and 6-month RECIST percentage was used. Relative changes in tumor metabolic volume (MTV) were also studied along with clinical parameters.
twelve consecutive patients with progressive metastatic siNET were included. One patient showed partial response at 6 months, the other were considered as stable disease. Linear regression showed that 6-month RECIST percentage and ∆SUVmax were strongly correlated with the following regression formula: 6-month RECIST = -0.05 + 0.36 x ∆SUVmax (p < 0.001). ∆MTV was not predictive of response.
we report a significant link between PTS ∆SUVmax and 6-month RECIST percentage in patients with siNET. Quantitative imaging would thus enable the prediction of 6-month response of 177Lu-DOTATATE as early as C2. These results need to be confirmed on a larger population.
用177Lu-DOTATATE进行肽受体放射性核素治疗已成为晚期小肠神经内分泌肿瘤（siNET）患者既定的二线治疗方法。治疗疗效在治疗结束数月后进行评估，且基于RECIST标准。治疗后闪烁显像（PTS）可在每个周期后进行，但其在早期反应评估中的价值存在争议，尤其是考虑到临床常规中缺乏定量分析。现在有了新的定量模块，可实现SUV的自动计算。本研究的主要目的是评估在定量PTS上，第一个（C1）和第二个（C2）周期之间SUV的变化在预测治疗反应方面的价值。纳入了所有转诊至我们中心接受177Lu-DOTATATE治疗的siNET患者。在C1和C2时，在PTS SPECT/CT上测量摄取量最大的病灶的SUVmax。计算∆SUVmax。使用∆SUVmax与6个月时RECIST百分比之间的线性回归。还研究了肿瘤代谢体积（MTV）的相对变化以及临床参数。
纳入了12例连续的进行性转移性siNET患者。1例患者在6个月时显示部分缓解，其他患者被视为疾病稳定。线性回归显示，6个月时RECIST百分比与∆SUVmax密切相关，回归公式如下：6个月时RECIST = -0.05 + 0.36 x ∆SUVmax（p < 0.001）。∆MTV不能预测反应。
我们报告了siNET患者中PTS ∆SUVmax与6个月时RECIST百分比之间存在显著关联。因此，定量成像能够早在C2时预测177Lu-DOTATATE的6个月反应。这些结果需要在更大规模的人群中得到证实。
