Andreas Pfeifer1, Ulrich Knigge2, Tina Binderup3, Jann Mortensen3, Peter Oturai3, Annika Loft3, Anne Kiil Berthelsen3, Seppo W Langer4, Palle Rasmussen5, Dennis Elema5, Eric von Benzon3, Liselotte Højgaard3, Andreas Kjaer6. 1. Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark Department of Nuclear Medicine, Helios-Klinikum Berlin-Buch, Berlin, Germany ENETS Center of Excellence for Neuroendocrine Tumors, Copenhagen, Denmark. 2. Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark ENETS Center of Excellence for Neuroendocrine Tumors, Copenhagen, Denmark Departments of Surgical Gastroenterology C and Medical Endocrinology, Rigshospitalet, Copenhagen, Denmark. 3. Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark ENETS Center of Excellence for Neuroendocrine Tumors, Copenhagen, Denmark. 4. ENETS Center of Excellence for Neuroendocrine Tumors, Copenhagen, Denmark Department of Oncology, Rigshospitalet, Copenhagen, Denmark; and. 5. Hevesy Laboratory, DTU-Risø, Roskilde, Denmark. 6. Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark ENETS Center of Excellence for Neuroendocrine Tumors, Copenhagen, Denmark akjaer@sund.ku.dk.
Abstract
UNLABELLED: Neuroendocrine tumors (NETs) can be visualized using radiolabeled somatostatin analogs. We have previously shown the clinical potential of (64)Cu-DOTATATE in a small first-in-human feasibility study. The aim of the present study was, in a larger prospective design, to compare on a head-to-head basis the performance of (64)Cu-DOTATATE and (111)In-diethylenetriaminepentaacetic acid (DTPA)-octreotide ((111)In-DTPA-OC) as a basis for implementing (64)Cu-DOTATATE as a routine. METHODS: We prospectively enrolled 112 patients with pathologically confirmed NETs of gastroenteropancreatic or pulmonary origin. All patients underwent both PET/CT with (64)Cu-DOTATATE and SPECT/CT with (111)In-DTPA-OC within 60 d. PET scans were acquired 1 h after injection of 202 MBq (range, 183-232 MBq) of (64)Cu-DOTATATE after a diagnostic contrast-enhanced CT scan. Patients were followed for 42-60 mo for evaluation of discrepant imaging findings. The McNemar test was used to compare the diagnostic performance. RESULTS: Eighty-seven patients were congruently PET- and SPECT-positive. No SPECT-positive cases were PET-negative, whereas 10 false-negative SPECT cases were identified using PET. The diagnostic sensitivity and accuracy of (64)Cu-DOTATATE (97% for both) were significantly better than those of (111)In-DTPA-OC (87% and 88%, respectively, P = 0.017). In 84 patients (75%), (64)Cu-DOTATATE identified more lesions than (111)In-DTPA-OC and always at least as many. In total, twice as many lesions were detected with (64)Cu-DOTATATE than with (111)In-DTPA-OC. Moreover, in 40 of 112 cases (36%) lesions were detected by (64)Cu-DOTATATE in organs not identified as disease-involved by (111)In-DTPA-OC. CONCLUSION: With these results, we demonstrate that (64)Cu-DOTATATE is far superior to (111)In-DTPA-OC in diagnostic performance in NET patients. Therefore, we do not hesitate to recommend implementation of (64)Cu-DOTATATE as a replacement for (111)In-DTPA-OC.
UNLABELLED: Neuroendocrine tumors (NETs) can be visualized using radiolabeled somatostatin analogs. We have previously shown the clinical potential of (64)Cu-DOTATATE in a small first-in-human feasibility study. The aim of the present study was, in a larger prospective design, to compare on a head-to-head basis the performance of (64)Cu-DOTATATE and (111)In-diethylenetriaminepentaacetic acid (DTPA)-octreotide ((111)In-DTPA-OC) as a basis for implementing (64)Cu-DOTATATE as a routine. METHODS: We prospectively enrolled 112 patients with pathologically confirmed NETs of gastroenteropancreatic or pulmonary origin. All patients underwent both PET/CT with (64)Cu-DOTATATE and SPECT/CT with (111)In-DTPA-OC within 60 d. PET scans were acquired 1 h after injection of 202 MBq (range, 183-232 MBq) of (64)Cu-DOTATATE after a diagnostic contrast-enhanced CT scan. Patients were followed for 42-60 mo for evaluation of discrepant imaging findings. The McNemar test was used to compare the diagnostic performance. RESULTS: Eighty-seven patients were congruently PET- and SPECT-positive. No SPECT-positive cases were PET-negative, whereas 10 false-negative SPECT cases were identified using PET. The diagnostic sensitivity and accuracy of (64)Cu-DOTATATE (97% for both) were significantly better than those of (111)In-DTPA-OC (87% and 88%, respectively, P = 0.017). In 84 patients (75%), (64)Cu-DOTATATE identified more lesions than (111)In-DTPA-OC and always at least as many. In total, twice as many lesions were detected with (64)Cu-DOTATATE than with (111)In-DTPA-OC. Moreover, in 40 of 112 cases (36%) lesions were detected by (64)Cu-DOTATATE in organs not identified as disease-involved by (111)In-DTPA-OC. CONCLUSION: With these results, we demonstrate that (64)Cu-DOTATATE is far superior to (111)In-DTPA-OC in diagnostic performance in NET patients. Therefore, we do not hesitate to recommend implementation of (64)Cu-DOTATATE as a replacement for (111)In-DTPA-OC.
Authors: Angela Spanu; Orazio Schillaci; Bastiana Piras; Diego F Calvisi; Antonio Falchi; Roberta Danieli; Susanna Nuvoli; Franca Dore; Giuseppe Madeddu Journal: Am J Nucl Med Mol Imaging Date: 2017-09-01
Authors: Rodney J Hicks; Price Jackson; Grace Kong; Robert E Ware; Michael S Hofman; David A Pattison; Timothy A Akhurst; Elizabeth Drummond; Peter Roselt; Jason Callahan; Roger Price; Charmaine M Jeffery; Emily Hong; Wayne Noonan; Alan Herschtal; Lauren J Hicks; Amos Hedt; Matthew Harris; Brett M Paterson; Paul S Donnelly Journal: J Nucl Med Date: 2018-11-15 Impact factor: 10.057
Authors: Ingrid H Olsen; Seppo W Langer; Birgitte H Federspiel; Jytte Oxbøl; Annika Loft; Anne Kiil Berthelsen; Jann Mortensen; Peter Oturai; Ulrich Knigge; Andreas Kjær Journal: Am J Nucl Med Mol Imaging Date: 2016-01-28
Authors: Esben Andreas Carlsen; Camilla Bardram Johnbeck; Tina Binderup; Mathias Loft; Andreas Pfeifer; Jann Mortensen; Peter Oturai; Annika Loft; Anne Kiil Berthelsen; Seppo W Langer; Ulrich Knigge; Andreas Kjaer Journal: J Nucl Med Date: 2020-02-28 Impact factor: 10.057