Anni Gålne1,2, Helen Almquist3, Martin Almquist4,5, Cecilia Hindorf6, Tomas Ohlsson6, Erik Nordenström4,5, Anna Sundlöv7,8, Elin Trägårdh3,2. 1. Department of Medical Imaging and Physiology, Skåne University Hospital, Lund and Malmö, Sweden anni.galne@med.lu.se. 2. Department of Translational Medicine, Lund University, Malmö, Sweden. 3. Department of Medical Imaging and Physiology, Skåne University Hospital, Lund and Malmö, Sweden. 4. Department of Surgery, Institution for Clinical Sciences, Lund University, Lund, Sweden. 5. Department of Surgery, Endocrine-Sarcoma Unit, Skåne University Hospital, Lund, Sweden. 6. Department of Radiation Physics, Skåne University Hospital, Lund, Sweden. 7. Department of Oncology and Pathology, Institution for Clinical Sciences, Lund University, Lund, Sweden; and. 8. Department of Oncology, Skåne University Hospital, Lund, Sweden.
Abstract
Patients with neuroendocrine tumors (NETs) are often treated with somatostatin analogs (SSAs) for control of symptoms and tumor growth. Such therapy could theoretically lead to misinterpretation of somatostatin receptor imaging with 68Ga-DOTATATE PET/CT by interfering with tracer-receptor binding. Guidelines recommend an interval of 3-4 wk between the last dose and imaging. The aim of this study was to evaluate if long-acting (LA) SSA treatment changes the uptake of 68Ga-DOTATATE in patients with NETs. Methods: From 2013 to 2016, 296 patients with, or under evaluation for, NETs were included in this prospective observational study. The effect of LA SSA on tracer uptake was evaluated in 2 main patient populations: those undergoing 68Ga-DOTATATE PET/CT before starting LA SSA treatment and at least once afterward, and those receiving ongoing LA SSA therapy, in whom the effect of the interval between the last dose of LA SSA and the PET/CT exam was analyzed. A third, explorative, analysis was performed to evaluate if clinical disease progression, regression, or stable tumor status changed the uptake of 68Ga-DOTATATE. In the 3 analyses, measurements of SUVmax in normal liver and tumor lesions were compared. Results: The median SUVmax in normal liver was significantly higher before treatment (8.6; interquartile range, 7.4-10.2) than after treatment initiation (6.0; 4.7-8.0) (P < 0.001). No significant changes in SUVmax were seen in tumor lesions after treatment initiation. No significant differences in SUVmax were found in normal liver or tumor lesions dependent on the interval between last dose of LA SSA and PET/CT. Conclusion: Treatment with LA SSA does not change SUVmax in tumor lesions, whereas SUVmax in normal liver is significantly lower after treatment. The findings have implications for interpretation of 68Ga-DOTATATE PET/CT for response assessment after SSA therapy and for guidelines on discontinuation of treatment before PET/CT.
Patients with neuroendocrine tumors (NETs) are often treated with somatostatin analogs (SSAs) for control of symptoms and tumor growth. Such therapy could theoretically lead to misinterpretation of somatostatin receptor imaging with 68Ga-DOTATATE PET/CT by interfering with tracer-receptor binding. Guidelines recommend an interval of 3-4 wk between the last dose and imaging. The aim of this study was to evaluate if long-acting (LA) SSA treatment changes the uptake of 68Ga-DOTATATE in patients with NETs. Methods: From 2013 to 2016, 296 patients with, or under evaluation for, NETs were included in this prospective observational study. The effect of LA SSA on tracer uptake was evaluated in 2 main patient populations: those undergoing 68Ga-DOTATATE PET/CT before starting LA SSA treatment and at least once afterward, and those receiving ongoing LA SSA therapy, in whom the effect of the interval between the last dose of LA SSA and the PET/CT exam was analyzed. A third, explorative, analysis was performed to evaluate if clinical disease progression, regression, or stable tumor status changed the uptake of 68Ga-DOTATATE. In the 3 analyses, measurements of SUVmax in normal liver and tumor lesions were compared. Results: The median SUVmax in normal liver was significantly higher before treatment (8.6; interquartile range, 7.4-10.2) than after treatment initiation (6.0; 4.7-8.0) (P < 0.001). No significant changes in SUVmax were seen in tumor lesions after treatment initiation. No significant differences in SUVmax were found in normal liver or tumor lesions dependent on the interval between last dose of LA SSA and PET/CT. Conclusion: Treatment with LA SSA does not change SUVmax in tumor lesions, whereas SUVmax in normal liver is significantly lower after treatment. The findings have implications for interpretation of 68Ga-DOTATATE PET/CT for response assessment after SSA therapy and for guidelines on discontinuation of treatment before PET/CT.
Authors: Alexander R Haug; Christoph J Auernhammer; Björn Wängler; Gerwin P Schmidt; Christopher Uebleis; Burkhard Göke; Paul Cumming; Peter Bartenstein; Reinhold Tiling; Marcus Hacker Journal: J Nucl Med Date: 2010-08-18 Impact factor: 10.057
Authors: Alexander R Haug; Axel Rominger; Mona Mustafa; Christoph Auernhammer; Burkhard Göke; Gerwin P Schmidt; Björn Wängler; Paul Cumming; Peter Bartenstein; Marcus Hacker Journal: J Nucl Med Date: 2011-10-05 Impact factor: 10.057
Authors: Dirk Mueller; Ingo Klette; Richard P Baum; M Gottschaldt; Michael K Schultz; Wouter A P Breeman Journal: Bioconjug Chem Date: 2012-07-19 Impact factor: 4.774
Authors: Konstantin P Zhernosekov; Dimitry V Filosofov; Richard P Baum; Peter Aschoff; Heiner Bihl; Anatoli A Razbash; Markus Jahn; Mark Jennewein; Frank Rösch Journal: J Nucl Med Date: 2007-09-14 Impact factor: 10.057
Authors: Anja Rinke; Michael Wittenberg; Carmen Schade-Brittinger; Behnaz Aminossadati; Erdmuthe Ronicke; Thomas M Gress; Hans-Helge Müller; Rudolf Arnold Journal: Neuroendocrinology Date: 2016-01-06 Impact factor: 4.914
Authors: Arvind Dasari; Chan Shen; Daniel Halperin; Bo Zhao; Shouhao Zhou; Ying Xu; Tina Shih; James C Yao Journal: JAMA Oncol Date: 2017-10-01 Impact factor: 31.777
Authors: Ka Kit Wong; Kirk A Frey; Jeremy Niedbala; Ravi K Kaza; Francis P Worden; Kellen J Fitzpatrick; Yuni K Dewaraja Journal: Nucl Med Commun Date: 2022-06-10 Impact factor: 1.698