Leupe Hannes, Ahmadi Bidakhvidi Niloefar, Goffin Karolien, Van den Broeck Bliede, Jentjens Sander, Laenen Annouschka, Pauwels Elin, Lybaert Willem, Van Cutsem Eric, Bormans Guy, Vandamme Timon, Cleeren Frederik, Dekervel Jeroen, Geboes Karen, Stroobants Sigrid, Verslype Chris, Deroose Christophe M
Nuclear Medicine, University Hospitals Leuven and Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
Nuclear Medicine, Department of Medical Imaging, Ghent University Hospital, Ghent, Belgium.
EJNMMI Rep. 2025 May 15;9(1):17. doi: 10.1186/s41824-025-00250-y.
This study compares inter- and intraobserver agreement between [F]AlF-NOTA-octreotide ([F]AlF-OC) and [Ga]Ga-DOTA-somatostatin analogues (SSAs) in PET/CT imaging for neuroendocrine neoplasm (NEN) patients.
This is a secondary endpoint analysis from our multicenter trial (clin trial.gov identifier: NCT04552847) including 75 NEN patients who received both [Ga]Ga-DOTATATE (n = 56) or [Ga]Ga-DOTA-NOC (n = 19) and [F]AlF-OC PET imaging. Five readers assessed lesion detection and characterization across multiple organs, scoring lesions by number and conspicuity using a 5-point Likert scale. Agreement was measured using Gwet's agreement coefficient.
Results demonstrated nearly perfect interobserver agreement for lesion characterization across all organs for both tracers (0.921 for [F]AlF-OC; 0.934 for [Ga]Ga-DOTA-SSA). Similar agreement was observed for the number of lesions across organs (0.736 for [F]AlF-OC and 0.749 for [Ga]Ga-DOTA-SSAs). Organ-specific analysis revealed strong agreement for bone and liver lesions, with slightly lower agreement for lymph nodes. Both tracers also showed excellent agreement in determining Krenning scores (0.925 for [F]AlF-OC and 0.927 for [Ga]Ga-DOTA-SSAs). While mean lesion conspicuity was similar between tracers, [F]AlF-OC had a higher global image quality score (4.22 vs. 3.86, p < 0.0001). Intraobserver agreement was consistent between tracers for lesion characterization (> 0.95 for both readers) and lesion count (> 0.80 for both readers).
[F]AlF-OC and [Ga]Ga-DOTA-SSAs demonstrate comparable and excellent inter- and intraobserver agreement, reinforcing the clinical interchangeability of [F]AlF-OC PET/CT with [Ga]Ga-DOTA-SSAs in routine practice.
本研究比较了[F]AlF-NOTA-奥曲肽（[F]AlF-OC）与[Ga]Ga-DOTA-生长抑素类似物（SSAs）在神经内分泌肿瘤（NEN）患者PET/CT成像中观察者间和观察者内的一致性。
这是我们多中心试验（临床试验.gov标识符：NCT04552847）的次要终点分析，该试验纳入了75例接受[Ga]Ga-DOTATATE（n = 56）或[Ga]Ga-DOTA-NOC（n = 19）以及[F]AlF-OC PET成像的NEN患者。五名阅片者评估了多个器官的病变检测和特征，使用5分李克特量表按数量和清晰度对病变进行评分。使用格韦特一致性系数测量一致性。
结果表明，两种示踪剂在所有器官的病变特征方面观察者间一致性近乎完美（[F]AlF-OC为0.921；[Ga]Ga-DOTA-SSA为0.934）。在各器官的病变数量方面也观察到类似的一致性（[F]AlF-OC为0.736，[Ga]Ga-DOTA-SSA为0.749）。器官特异性分析显示，骨和肝病变的一致性较强，淋巴结的一致性略低。两种示踪剂在确定克伦宁评分方面也显示出极好的一致性（[F]AlF-OC为0.925，[Ga]Ga-DOTA-SSA为0.927）。虽然两种示踪剂之间的平均病变清晰度相似，但[F]AlF-OC的整体图像质量评分更高（4.22对3.86，p < 0.0001）。观察者内一致性在两种示踪剂的病变特征方面是一致的（两位阅片者均> 0.95），在病变计数方面也是一致的（两位阅片者均> 0.80）。
[F]AlF-OC和[Ga]Ga-DOTA-SSA在观察者间和观察者内均显示出相当且出色的一致性，这加强了在常规实践中[F]AlF-OC PET/CT与[Ga]Ga-DOTA-SSA的临床互换性。
