Vittoria Rufini1,2,3, Margherita Lorusso4,5, Frediano Inzani4,6, Tina Pasciuto7, Elizabeth Katherine Anna Triumbari8, Lucia Rosalba Grillo9, Filippo Locco10,11, Stefano Margaritora10,11, Edoardo Pescarmona12, Guido Rindi4,6,13. 1. Section of Nuclear Medicine, University Department of Radiological Sciences and Hematology, Università Cattolica del Sacro Cuore, Rome, Italy. Vittoria.Rufini@unicatt.it. 2. Unit of Nuclear Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Vittoria.Rufini@unicatt.it. 3. ENETS Center of Excellence for the Diagnosis and Cure of Neuroendocrine Tumors, Rome, Italy. Vittoria.Rufini@unicatt.it. 4. ENETS Center of Excellence for the Diagnosis and Cure of Neuroendocrine Tumors, Rome, Italy. 5. PET/CT Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. 6. Unit of Pathology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 7. Research Core Facility Data Collection G-STeP, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 8. Section of Nuclear Medicine, University Department of Radiological Sciences and Hematology, Università Cattolica del Sacro Cuore, Rome, Italy. 9. Pathology Unit, San Camillo-Forlanini Hospitals, Rome, Italy. 10. Section of Thoracic Surgery, Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy. 11. Unit of Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 12. Pathology Unit, 'Regina Elena' National Cancer Institute IRCCS, Rome, Italy. 13. Section of Pathology, Department of Woman and Child Health and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
Abstract
PURPOSE: To correlate somatostatin receptor (SSTR) and proliferative activity profile (SSTR2, SSTR5, Ki-67) at immunohistochemistry (IHC) with SSTR-PET/CT imaging features in a retrospective series of lung neuroendocrine tumors (NET). Proliferative activity by Ki-67 and 18F-FDG-PET/CT parameters (when available) were also correlated. METHODS: Among 551 patients who underwent SSTR-PET/CT with 68Ga-DOTA-somatostatin analogs (SSA) between July 2011 and March 2020 for lung neuroendocrine neoplasms, 32 patients with a confirmed diagnosis of NET were included. For 14 of them, 18F-FDG-PET/CT was available. PET/CT images were reviewed by qualitative and semi-quantitative analyses. Immunohistochemistry for SSTR2, SSTR5, and Ki-67 was assessed. Inferential analysis was performed including kappa statistics and Spearman's rank correlation test. RESULTS: Definitive diagnosis consisted of 26 typical carcinoids-G1 and six atypical carcinoids-G2. Positive SSTR2-IHC was found in 62.5% of samples while SSTR5-IHC positivity was 19.4%. A correlation between SSTR2-IHC and SSTR-PET/CT was found in 24/32 cases (75.0%, p = 0.003): 20 were concordantly positive, 4 concordantly negative. For positive IHC, 100% concordance with SSTR-PET/CT (both positive) was observed, while for negative IHC concordance (both negative) was 33.3%. In 8 cases, IHC was negative while SSTR-PET/CT was positive, even though with low-grade uptake in all but one. A significant correlation between SUVmax values at SSTR-PET/CT and the SSTR2-IHC scores was found, with low SUVmax values corresponding to negative IHC and higher SUVmax values to positive IHC (p = 0.002). CONCLUSION: This retrospective study showed an overall good agreement between SSTR2-IHC and tumor uptake at SSTR-PET/CT in lung NETs. SSTR-PET/CT SUVmax values can be used as a parameter of SSTR2 density. Within the limits imposed by the relatively small cohort, our data suggest that SSTR2-IHC may surrogate SSTR-PET/CT in selected lung NET patients for clinical decision making when SSTR-PET/CT is not available.
PURPOSE: To correlate somatostatin receptor (SSTR) and proliferative activity profile (SSTR2, SSTR5, Ki-67) at immunohistochemistry (IHC) with SSTR-PET/CT imaging features in a retrospective series of lung neuroendocrine tumors (NET). Proliferative activity by Ki-67 and 18F-FDG-PET/CT parameters (when available) were also correlated. METHODS: Among 551 patients who underwent SSTR-PET/CT with 68Ga-DOTA-somatostatin analogs (SSA) between July 2011 and March 2020 for lung neuroendocrine neoplasms, 32 patients with a confirmed diagnosis of NET were included. For 14 of them, 18F-FDG-PET/CT was available. PET/CT images were reviewed by qualitative and semi-quantitative analyses. Immunohistochemistry for SSTR2, SSTR5, and Ki-67 was assessed. Inferential analysis was performed including kappa statistics and Spearman's rank correlation test. RESULTS: Definitive diagnosis consisted of 26 typical carcinoids-G1 and six atypical carcinoids-G2. Positive SSTR2-IHC was found in 62.5% of samples while SSTR5-IHC positivity was 19.4%. A correlation between SSTR2-IHC and SSTR-PET/CT was found in 24/32 cases (75.0%, p = 0.003): 20 were concordantly positive, 4 concordantly negative. For positive IHC, 100% concordance with SSTR-PET/CT (both positive) was observed, while for negative IHC concordance (both negative) was 33.3%. In 8 cases, IHC was negative while SSTR-PET/CT was positive, even though with low-grade uptake in all but one. A significant correlation between SUVmax values at SSTR-PET/CT and the SSTR2-IHC scores was found, with low SUVmax values corresponding to negative IHC and higher SUVmax values to positive IHC (p = 0.002). CONCLUSION: This retrospective study showed an overall good agreement between SSTR2-IHC and tumor uptake at SSTR-PET/CT in lung NETs. SSTR-PET/CT SUVmax values can be used as a parameter of SSTR2 density. Within the limits imposed by the relatively small cohort, our data suggest that SSTR2-IHC may surrogate SSTR-PET/CT in selected lung NET patients for clinical decision making when SSTR-PET/CT is not available.
Authors: Simron Singh; Emily K Bergsland; Cynthia M Card; Thomas A Hope; Pamela L Kunz; David T Laidley; Ben Lawrence; Simone Leyden; David C Metz; Michael Michael; Lucy E Modahl; Sten Myrehaug; Sukhmani K Padda; Rodney F Pommier; Robert A Ramirez; Michael Soulen; Jonathan Strosberg; Arthur Sung; Alia Thawer; Benjamin Wei; Bin Xu; Eva Segelov Journal: J Thorac Oncol Date: 2020-07-11 Impact factor: 15.609
Authors: Elgin G R Lichtenauer-Kaligis; Virgil A S H Dalm; Sigrid P M A Oomen; Diana M Mooij; P Martin van Hagen; Steven W J Lamberts; Leo J Hofland Journal: Eur J Endocrinol Date: 2004-04 Impact factor: 6.664
Authors: Elske Quak; Pierre-Yves Le Roux; Michael S Hofman; Philippe Robin; David Bourhis; Jason Callahan; David Binns; Cédric Desmonts; Pierre-Yves Salaun; Rodney J Hicks; Nicolas Aide Journal: Eur J Nucl Med Mol Imaging Date: 2015-07-30 Impact factor: 9.236