Camilla B Johnbeck1,2, Ulrich Knigge2,3, Annika Loft1,2, Anne K Berthelsen1,2, Jann Mortensen1,2, Peter Oturai1,2, Seppo W Langer2,4, Dennis R Elema5, Andreas Kjaer6,2. 1. Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark. 2. ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark. 3. Department of Surgical Gastroenterology and Department of Clinical Endocrinology, Rigshospitalet, Copenhagen, Denmark. 4. Department of Oncology, Rigshospitalet, Copenhagen, Denmark; and. 5. Hevesy Laboratory, DTU Nutech, Technical University of Denmark, Roskilde, Denmark. 6. Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark akjaer@sund.ku.dk.
Abstract
Somatostatin receptor imaging is a valuable tool in the diagnosis, follow-up, and treatment planning of neuroendocrine tumor (NET). PET-based tracers using 68Ga as the radioisotope have in most centers replaced SPECT-based tracers as the gold standard. 64Cu-DOTATATE is a new PET tracer that has been shown to be far superior to the SPECT tracer 111In-diethylenetriaminepentaacetic acid-octreotide. Because of the advantages of 64Cu over 68Ga, we hypothesized that the tracer has a higher sensitivity than 68Ga-based tracers. To test this hypothesis, we compared on a head-to-head basis the diagnostic performance of 64Cu-DOTATATE with that of 68Ga-DOTATOC in NET patients. Methods: Fifty-nine NET patients were scanned with both 64Cu-DOTATATE and 68Ga-DOTATOC PET/CT and compared on a head-to-head basis. Discordant lesions were verified during at least 30 mo of follow-up. Results: A total of 701 lesions were concordantly detected on both 64Cu-DOTATATE and 68Ga-DOTATOC PET/CT scans, whereas an additional 68 lesions were found by only one of the scans. 64Cu-DOTATATE showed 42 lesions not found on 68Ga-DOTATOC, of which 33 were found to be true-positive on follow-up. 68Ga-DOTATOC showed 26 lesions not found on 64Cu-DOTATATE, of which 7 were found to be true-positive on follow-up. False-positives were mainly lymph node lesions. Accordingly, 83% of the additional true lesions found on only one of the scans were found by 64Cu-DOTATATE. On a patient-basis, additional true lesions were found by 64Cu-DOTATATE and 68Ga-DOTATOC in 13 and 3 patients, respectively. All patients with additional lesions also had concordant lesions found by both scans. Conclusion: 64Cu-DOTATATE has advantages over 68Ga-DOTATOC in the detection of lesions in NET patients. Although patient-based sensitivity was the same for 64Cu-DOTATATE and 68Ga-DOTATOC in this cohort, significantly more lesions were detected by 64Cu-DOTATATE. Furthermore, the shelf life of more than 24 h and the scanning window of at least 3 h make 64Cu-DOTATATE favorable and easy to use in the clinical setting.
Somatostatin receptor imaging is a valuable tool in the diagnosis, follow-up, and treatment planning of neuroendocrine tumor (NET). PET-based tracers using 68Ga as the radioisotope have in most centers replaced SPECT-based tracers as the gold standard. 64Cu-DOTATATE is a new PET tracer that has been shown to be far superior to the SPECT tracer 111In-diethylenetriaminepentaacetic acid-octreotide. Because of the advantages of 64Cu over 68Ga, we hypothesized that the tracer has a higher sensitivity than 68Ga-based tracers. To test this hypothesis, we compared on a head-to-head basis the diagnostic performance of 64Cu-DOTATATE with that of 68Ga-DOTATOC in NET patients. Methods: Fifty-nine NET patients were scanned with both 64Cu-DOTATATE and 68Ga-DOTATOC PET/CT and compared on a head-to-head basis. Discordant lesions were verified during at least 30 mo of follow-up. Results: A total of 701 lesions were concordantly detected on both 64Cu-DOTATATE and 68Ga-DOTATOC PET/CT scans, whereas an additional 68 lesions were found by only one of the scans. 64Cu-DOTATATE showed 42 lesions not found on 68Ga-DOTATOC, of which 33 were found to be true-positive on follow-up. 68Ga-DOTATOC showed 26 lesions not found on 64Cu-DOTATATE, of which 7 were found to be true-positive on follow-up. False-positives were mainly lymph node lesions. Accordingly, 83% of the additional true lesions found on only one of the scans were found by 64Cu-DOTATATE. On a patient-basis, additional true lesions were found by 64Cu-DOTATATE and 68Ga-DOTATOC in 13 and 3 patients, respectively. All patients with additional lesions also had concordant lesions found by both scans. Conclusion:64Cu-DOTATATE has advantages over 68Ga-DOTATOC in the detection of lesions in NET patients. Although patient-based sensitivity was the same for 64Cu-DOTATATE and 68Ga-DOTATOC in this cohort, significantly more lesions were detected by 64Cu-DOTATATE. Furthermore, the shelf life of more than 24 h and the scanning window of at least 3 h make 64Cu-DOTATATE favorable and easy to use in the clinical setting.
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: 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
Authors: Tina Binderup; Ulrich Knigge; Camilla Bardram Johnbeck; Annika Loft; Anne Kiil Berthelsen; Peter Oturai; Jann Mortensen; Birgitte Federspiel; Seppo W Langer; Andreas Kjaer Journal: J Nucl Med Date: 2020-10-16 Impact factor: 10.057