Yusuf Menda1, Thomas M O'Dorisio2, James R Howe3, Michael Schultz4, Joseph S Dillon2, David Dick4, G Leonard Watkins4, Timothy Ginader5, David L Bushnell4, John J Sunderland4, Gideon K D Zamba6, Michael Graham4, M Sue O'Dorisio7. 1. Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa yusuf-menda@uiowa.edu. 2. Department of Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. 3. Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa. 4. Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa. 5. Holden Comprehensive Cancer Center, University of Iowa Carver College of Medicine, Iowa City, Iowa. 6. Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa; and. 7. Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa.
Abstract
Localization of the site of the unknown primary tumor is critical for surgical treatment of patients presenting with neuroendocrine tumor (NET) with metastases. Methods: Forty patients with metastatic NET and unknown primary site underwent 68Ga-DOTATOC PET/CT in a single-site prospective study. The 68Ga-DOTATOC PET/CT was considered true-positive if the positive primary site was confirmed by histology or follow-up imaging. The scan was considered false-positive if no primary lesion was found corresponding to the 68Ga-DOTATOC-positive site. All negative scans for primary tumor were considered false-negative. A scan was classified unconfirmed if 68Ga-DOTATOC PET/CT suggested a primary, however, no histology was obtained and imaging follow-up was not confirmatory. Results: The true-positive, false-positive, false-negative, and unconfirmed rates for unknown primary tumor were 38%, 7%, 50%, and 5%, respectively. Conclusion: 68Ga-DOTATOC PET/CT is an effective modality in the localization of unknown primary in patients with metastatic NET.
Localization of the site of the unknown primary tumor is critical for surgical treatment of patients presenting with neuroendocrine tumor (NET) with metastases. Methods: Forty patients with metastatic NET and unknown primary site underwent 68Ga-DOTATOC PET/CT in a single-site prospective study. The 68Ga-DOTATOC PET/CT was considered true-positive if the positive primary site was confirmed by histology or follow-up imaging. The scan was considered false-positive if no primary lesion was found corresponding to the 68Ga-DOTATOC-positive site. All negative scans for primary tumor were considered false-negative. A scan was classified unconfirmed if 68Ga-DOTATOC PET/CT suggested a primary, however, no histology was obtained and imaging follow-up was not confirmatory. Results: The true-positive, false-positive, false-negative, and unconfirmed rates for unknown primary tumor were 38%, 7%, 50%, and 5%, respectively. Conclusion: 68Ga-DOTATOC PET/CT is an effective modality in the localization of unknown primary in patients with metastatic NET.
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