David L Chan1,2, Gary A Ulaner3, David Pattison4,5, David Wyld5,6, Rahul Ladwa5,6, Julian Kirchner3, Bob T Li7, W Victoria Lai7, Nick Pavlakis8,2, Paul J Roach9,10, Dale L Bailey9,10,11. 1. Department of Medical Oncology, Royal North Shore Hospital, St. Leonards, New South Wales, Australia; david.chan@sydney.edu.au. 2. Bill Walsh Translational Cancer Research Laboratory, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia. 3. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York. 4. Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. 5. School of Medicine, University of Queensland, Brisbane, Queensland, Australia. 6. Department of Medical Oncology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. 7. Department of Thoracic Oncology, Memorial Sloan Kettering Cancer Center, New York, New York. 8. Department of Medical Oncology, Royal North Shore Hospital, St. Leonards, New South Wales, Australia. 9. Department of Nuclear Medicine, Royal North Shore Hospital, St. Leonards, New South Wales, Australia. 10. Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; and. 11. Sydney Vital Translational Cancer Research Centre, Sydney, New South Wales, Australia.
Abstract
PET scans using 18F-FDG and somatostatin receptor imaging agents are both used in imaging of neuroendocrine neoplasms (NENs). We have suggested the "NETPET score," using uptake of both PET tracers, as a prognostic biomarker in NENs. The name NETPET score was suggested previously to capture the score's intent to summarize information from dual PET imaging in neuroendocrine tumors. We previously demonstrated the effectiveness of the NETPET score in gastroenteropancreatic NENs (GEPNENs). Its prognostic relevance in bronchial NENs remains undetermined. Methods: This is a retrospective multicenter study (2011-2018) assessing patients who had advanced bronchial NEN and who underwent both 18F-FDG and 68Ga-DOTATATE PET within 60 d of each other. The NETPET score was assigned by experienced nuclear medicine physicians and compared with other clinical data such as World Health Organization grade. The primary outcome was overall survival; NETPET score and other prognostic variables were analyzed using univariate and multivariate analyses by the Cox proportional-hazards model. Results: Thirty-eight patients were included for review. The NETPET score and histology were significantly correlated with overall survival in univariate analyses (P = 0.003, P = 0.01). On multivariate analysis, only the NETPET score remained significant (P = 0.03). The NETPET score was significantly associated with histologic grade (P = 0.006, χ2 test). Conclusion: The NETPET score is a prognostic biomarker in bronchial NENs as well as GEPNENs. Although it needs to be validated in prospective studies, it holds significant promise as a biomarker for a wide range of NENs.
PET scans using 18F-FDG and somatostatin receptor imaging agents are both used in imaging of neuroendocrine neoplasms (NENs). We have suggested the "NETPET score," using uptake of both PET tracers, as a prognostic biomarker in NENs. The name NETPET score was suggested previously to capture the score's intent to summarize information from dual PET imaging in neuroendocrine tumors. We previously demonstrated the effectiveness of the NETPET score in gastroenteropancreatic NENs (GEPNENs). Its prognostic relevance in bronchial NENs remains undetermined. Methods: This is a retrospective multicenter study (2011-2018) assessing patients who had advanced bronchial NEN and who underwent both 18F-FDG and 68Ga-DOTATATE PET within 60 d of each other. The NETPET score was assigned by experienced nuclear medicine physicians and compared with other clinical data such as World Health Organization grade. The primary outcome was overall survival; NETPET score and other prognostic variables were analyzed using univariate and multivariate analyses by the Cox proportional-hazards model. Results: Thirty-eight patients were included for review. The NETPET score and histology were significantly correlated with overall survival in univariate analyses (P = 0.003, P = 0.01). On multivariate analysis, only the NETPET score remained significant (P = 0.03). The NETPET score was significantly associated with histologic grade (P = 0.006, χ2 test). Conclusion: The NETPET score is a prognostic biomarker in bronchial NENs as well as GEPNENs. Although it needs to be validated in prospective studies, it holds significant promise as a biomarker for a wide range of NENs.
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