Simron Singh, Raymond Poon1, Rebecca Wong2, Ur Metser3. 1. Department of Oncology, Program in Evidence-Based Care, Cancer Care Ontario, McMaster University, Juravinski Hospital and Cancer Centre, Hamilton. 2. Department of Radiation Oncology, University of Toronto and Princess Margaret Hospital, University Health Network. 3. Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital, and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.
Abstract
PURPOSE: The aim of this study was to systematically review the literature to assess the role of Ga PET imaging in neuroendocrine tumors (NETs). MATERIALS AND METHODS: The literature was searched using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews databases through OVID. Studies comparing PET or PET/CT with conventional imaging in the initial diagnosis, staging and restaging, assessment of treatment response, and routine surveillance of NETs were deemed eligible for inclusion. Risk of bias and applicability concerns were assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. RESULTS: Twenty-two studies met the inclusion criteria. For the initial diagnosis of NETs, PET or PET/CT had a pooled sensitivity of 91% (95% confidence interval [CI], 85%-94%) and a pooled specificity of 94% (95% CI, 86%-98%). In the setting of staging and restaging, the sensitivity of PET or PET/CT for detecting primary and/or metastatic lesions ranged from 78.3% to 100%, whereas specificity ranged from 83% to 100%. Change in management occurred in 45% (95% CI, 36%-55%) of the cases, with majority of the changes involving surgical planning and patient selection for peptide receptor radionuclide therapy. CONCLUSIONS: Ga PET or PET/CT is recommended for initial diagnosis where conventional testing remained equivocal, for staging of patients with localized primary and/or limited metastasis where definitive surgery is planned, to determine somatostatin receptor status and suitability for peptide receptor radionuclide therapy, and for staging of patients where detection of occult disease will alter treatment options and decision making.
PURPOSE: The aim of this study was to systematically review the literature to assess the role of Ga PET imaging in neuroendocrine tumors (NETs). MATERIALS AND METHODS: The literature was searched using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews databases through OVID. Studies comparing PET or PET/CT with conventional imaging in the initial diagnosis, staging and restaging, assessment of treatment response, and routine surveillance of NETs were deemed eligible for inclusion. Risk of bias and applicability concerns were assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. RESULTS: Twenty-two studies met the inclusion criteria. For the initial diagnosis of NETs, PET or PET/CT had a pooled sensitivity of 91% (95% confidence interval [CI], 85%-94%) and a pooled specificity of 94% (95% CI, 86%-98%). In the setting of staging and restaging, the sensitivity of PET or PET/CT for detecting primary and/or metastatic lesions ranged from 78.3% to 100%, whereas specificity ranged from 83% to 100%. Change in management occurred in 45% (95% CI, 36%-55%) of the cases, with majority of the changes involving surgical planning and patient selection for peptide receptor radionuclide therapy. CONCLUSIONS:Ga PET or PET/CT is recommended for initial diagnosis where conventional testing remained equivocal, for staging of patients with localized primary and/or limited metastasis where definitive surgery is planned, to determine somatostatin receptor status and suitability for peptide receptor radionuclide therapy, and for staging of patients where detection of occult disease will alter treatment options and decision making.
Authors: Michael Messerli; Virginia Liberini; Hannes Grünig; Alexander Maurer; Stephan Skawran; Niklas Lohaus; Lars Husmann; Erika Orita; Josephine Trinckauf; Philipp A Kaufmann; Martin W Huellner Journal: Br J Radiol Date: 2021-09-14 Impact factor: 3.629
Authors: Daphne M V Huizing; Daniëlle Koopman; Jorn A van Dalen; Martin Gotthardt; Ronald Boellaard; Terez Sera; Michiel Sinaasappel; Marcel P M Stokkel; Berlinda J de Wit-van der Veen Journal: EJNMMI Phys Date: 2019-11-08
Authors: Hunor Kertész; Thomas Beyer; Vladimir Panin; Walter Jentzen; Jacobo Cal-Gonzalez; Alexander Berger; Laszlo Papp; Peter L Kench; Deepak Bharkhada; Jorge Cabello; Maurizio Conti; Ivo Rausch Journal: Front Physiol Date: 2022-03-08 Impact factor: 4.566