Clinical value of 68Ga-DOTATATE-PET/CT compared to stand-alone contrast enhanced CT for the detection of extra-hepatic metastases in patients with neuroendocrine tumours (NET)

• DOI: 10.1016/j.ejrad.2015.06.024
• Publication Date: 2015-07-02T18:46:04Z
• Authors: D.R. Albanus; J. Apitzsch; Z. Erdem; O. Erdem; F.A. Verburg; F.F. Behrendt; F.M. Mottaghy; A. Heinzel
• Keywords: BONE METASTASES; PET/CT; Extra hepatic metastasis; GA-68-DOTA-TYR(3)-OCTREOTIDE PET; GUIDELINES; 68Ga-DOTA-TATEPET/CT; DISEASE; LIVER METASTASES; 3. Good health; Extra-hepatic metastasisa; 03 medical and health sciences; 0302 clinical medicine; Ga-68-DOTA-TATE; Neuroendocrine tumour; SURVIVAL; SCINTIGRAPHY; GA-68-DOTA-TATE

PURPOSE: To compare and outline the beneficial skills of combined (68)Ga-DOTATATE positron emission tomography (PET) with concurrent contrast enhanced X-ray computed tomography (ceCT) against stand-alone ceCT in 54 patients with neuroendocrine tumours (NET). METHODS: Patients with histologically confirmed NET and available follow-up of at least 6 months (median 12.6 months; range 6.1-23.2) were included. PET/CT and ceCT images were initially analyzed separately by two blinded nuclear medicine physicians and two radiologists, respectively. In a second step all four physicians reviewed all detected lesions together reaching a consensus-grading for PET/ceCT. The results were then compared to the reference standard consisting of clinical follow-up data. RESULTS: With regard to true positive lesions, PET/ceCT vs. stand alone ceCT detected 139 vs. 48 bone-lesions, 106 vs. 71 lymph node metastases and 26 vs. 26 pulmonary lesions. On a per-patient basis, PET/ceCT achieved a higher sensitivity (100% vs. 47%) and specificity (89% vs. 49%) for bone lesions than ceCT. For lymph nodes the effect was similar (sensitivity 92% vs. 64% and specificity 83% vs. 59%). For the detection of pulmonary lesions the sensitivity was identical (100%) while specificity of PET/ceCT was superior to ceCT-alone (95% vs. 82%). CONCLUSION: In summary, the use of (68)Ga-DOTATATE PET/ceCT leads to an increase in sensitivity and specificity in the detection of extra-hepatic NET metastases compared to stand-alone ceCT. Therefore, (68)Ga-DOTATATE PET/ceCT should be the imaging modality of choice in patients with NET.