S Van Binnebeek1, B Vanbilloen1, K Baete1, C Terwinghe1, M Koole1, F M Mottaghy2,3, P M Clement4, L Mortelmans1, K Bogaerts5, K Haustermans6, K Nackaerts7, E Van Cutsem8, C Verslype8, A Verbruggen9, C M Deroose10,11. 1. Nuclear Medicine, University Hospitals Leuven and Department of Imaging and Pathology, KU Leuven, Leuven, Belgium. 2. Department of Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands. 3. Department of Nuclear Medicine, University Hospital Aachen, Aachen, Germany. 4. Medical Oncology, University Hospitals Leuven and Laboratory of Experimental Oncology, KU Leuven, Leuven, Belgium. 5. Department of Public Health and Primary Care (I-BioStat), KU Leuven and UHasselt, Leuven, Belgium. 6. Radiation Oncology, University Hospitals Leuven and Department of Oncology, KU Leuven, Leuven, Belgium. 7. Pulmonology, University Hospitals Leuven, Leuven, Belgium. 8. Division of Digestive Oncology, University Hospitals Leuven and Department of Oncology, KU Leuven, Leuven, Belgium. 9. Laboratory for Radiopharmacy, KU Leuven, Leuven, Belgium. 10. Nuclear Medicine, University Hospitals Leuven and Department of Imaging and Pathology, KU Leuven, Leuven, Belgium. christophe.deroose@uzleuven.be. 11. Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium. christophe.deroose@uzleuven.be.
Abstract
OBJECTIVES: To compare the diagnostic accuracy of (111)In-pentetreotide-scintigraphy with (68)Ga-DOTATOC-positron emission tomography (PET)/computed tomography (CT) in patients with metastatic-neuroendocrine tumour (NET) scheduled for peptide receptor radionuclide therapy (PRRT). Incremental lesions (ILs) were defined as lesions observed on only one modality. METHODS: Fifty-three metastatic-NET-patients underwent (111)In-pentetreotide-scintigraphy (24 h post-injection; planar+single-photon emission CT (SPECT) abdomen) and whole-body (68)Ga-DOTATOC-PET/CT. SPECT and PET were compared in a lesion-by-lesion and organ-by-organ analysis, determining the total lesions and ILs for both modalities. RESULTS: Significantly more lesions were detected on (68)Ga-DOTATOC-PET/CT versus (111)In-pentetreotide-scintigraphy. More specifically, we observed 1,098 lesions on PET/CT (range: 1-105; median: 15) versus 660 on SPECT (range: 0-73, median: 9) (p<0.0001), with 439 PET-ILs (42/53 patients) and one SPECT-IL (1/53 patients). The sensitivity for PET/CT was 99.9 % (95 % CI, 99.3-100.0), for SPECT 60.0 % (95 % CI, 48.5-70.2). The organ-by-organ analysis showed that the PET-ILs were most frequently visualized in liver and skeleton. CONCLUSION: Ga-DOTATOC-PET/CT is superior for the detection of NET-metastases compared to (111)In-pentetreotide SPECT. KEY POINTS: Somatostatin receptor PET is superior to SPECT in detecting NET metastases. PET is the scintigraphic method for accurate depiction of NET tumour burden. The sensitivity of PET is twofold higher than the sensitivity of SPECT.
OBJECTIVES: To compare the diagnostic accuracy of (111)In-pentetreotide-scintigraphy with (68)Ga-DOTATOC-positron emission tomography (PET)/computed tomography (CT) in patients with metastatic-neuroendocrine tumour (NET) scheduled for peptide receptor radionuclide therapy (PRRT). Incremental lesions (ILs) were defined as lesions observed on only one modality. METHODS: Fifty-three metastatic-NET-patients underwent (111)In-pentetreotide-scintigraphy (24 h post-injection; planar+single-photon emission CT (SPECT) abdomen) and whole-body (68)Ga-DOTATOC-PET/CT. SPECT and PET were compared in a lesion-by-lesion and organ-by-organ analysis, determining the total lesions and ILs for both modalities. RESULTS: Significantly more lesions were detected on (68)Ga-DOTATOC-PET/CT versus (111)In-pentetreotide-scintigraphy. More specifically, we observed 1,098 lesions on PET/CT (range: 1-105; median: 15) versus 660 on SPECT (range: 0-73, median: 9) (p<0.0001), with 439 PET-ILs (42/53 patients) and one SPECT-IL (1/53 patients). The sensitivity for PET/CT was 99.9 % (95 % CI, 99.3-100.0), for SPECT 60.0 % (95 % CI, 48.5-70.2). The organ-by-organ analysis showed that the PET-ILs were most frequently visualized in liver and skeleton. CONCLUSION:Ga-DOTATOC-PET/CT is superior for the detection of NET-metastases compared to (111)In-pentetreotide SPECT. KEY POINTS: Somatostatin receptor PET is superior to SPECT in detecting NET metastases. PET is the scintigraphic method for accurate depiction of NET tumour burden. The sensitivity of PET is twofold higher than the sensitivity of SPECT.
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