Ophélie Bélissant Benesty1, Valérie Nataf2, Jessica Ohnona2, Laure Michaud2, Jules Zhang-Yin2, Jérôme Bertherat3, Philippe Chanson4, Yves Reznik5, Jean-Noël Talbot2, Françoise Montravers2. 1. Nuclear Medicine, Hôpital Tenon APHP and Sorbonne University, Paris, France. ophelie.benesty@gmail.com. 2. Nuclear Medicine, Hôpital Tenon APHP and Sorbonne University, Paris, France. 3. Endocrinology, Hôpital Cochin APHP and Paris Descartes University, Paris, France. 4. Endocrinology, Hôpital Bicêtre APHP and Université Paris Sud, Le Kremlin-Bicêtre, France. 5. Endocrinology, Centre Hospitalo-Universitaire de Caen and Université de Caen Normandie, Caen, France.
Abstract
PURPOSE: Paraneoplastic Cushing's syndrome (PCS) is frequently caused by neuroendocrine tumours (NETs). Approximately 20% of tumours are still occult years later. Gallium-68 somatostatin receptor-PET/CT is promising for the detection of the causal primary NET, but its role in case of recurrent PCS is rarely reported. We report our experience with DOTATOC PET/CT in localising the causal NET in cases of initial but also recurrent PCS, and its clinical impact. METHODS: A retrospective review of all DOTATOC PET/CTs performed in consecutive patients referred for PCS to our centre, between January 2011 and June 2017, was done. Nineteen patients underwent 26 PET/CTs, 13 for detection of a primary NET, seven for persistent or recurrent PCS after resection, and six for surveillance after resection of NETs previously detected on a DOTATOC PET/CT in our centre. RESULTS: Among the 13 PET/CTs performed to search for primary NET, five were positive: four carcinoid lung tumours were confirmed after resection and one lung focus was not confirmed since surgery would have carried a high risk. Clinical impact was 23% (3/13). Among the seven PET/CTs performed for persistent or recurrent PCS, six were true-positive, with confirmation of metastatic lymph nodes after resection. Clinical impact was 57% (4/7). All PET/CTs performed for surveillance were true-negative. CONCLUSIONS: DOTATOC PET/CT seems to be a valuable tool for detection of the NET responsible for persistent or recurrent PCS after surgery. In this context, DOTATOC PET/CT was more effective than for the detection of the causal tumour in initial PCS.
PURPOSE:Paraneoplastic Cushing's syndrome (PCS) is frequently caused by neuroendocrine tumours (NETs). Approximately 20% of tumours are still occult years later. Gallium-68 somatostatin receptor-PET/CT is promising for the detection of the causal primary NET, but its role in case of recurrent PCS is rarely reported. We report our experience with DOTATOC PET/CT in localising the causal NET in cases of initial but also recurrent PCS, and its clinical impact. METHODS: A retrospective review of all DOTATOC PET/CTs performed in consecutive patients referred for PCS to our centre, between January 2011 and June 2017, was done. Nineteen patients underwent 26 PET/CTs, 13 for detection of a primary NET, seven for persistent or recurrent PCS after resection, and six for surveillance after resection of NETs previously detected on a DOTATOC PET/CT in our centre. RESULTS: Among the 13 PET/CTs performed to search for primary NET, five were positive: four carcinoid lung tumours were confirmed after resection and one lung focus was not confirmed since surgery would have carried a high risk. Clinical impact was 23% (3/13). Among the seven PET/CTs performed for persistent or recurrent PCS, six were true-positive, with confirmation of metastatic lymph nodes after resection. Clinical impact was 57% (4/7). All PET/CTs performed for surveillance were true-negative. CONCLUSIONS: DOTATOC PET/CT seems to be a valuable tool for detection of the NET responsible for persistent or recurrent PCS after surgery. In this context, DOTATOC PET/CT was more effective than for the detection of the causal tumour in initial PCS.
Authors: Valentina Di Ruscio; Giada Del Baldo; Maria Debora De Pasquale; Rita De Vito; Evelina Miele; Giovanna Stefania Colafati; Annalisa Deodati; Maria Antonietta De Ioris; Assunta Tornesello; Giuseppe Maria Milano; Angela Mastronuzzi Journal: Front Oncol Date: 2020-04-28 Impact factor: 6.244