Visualization of somatostatin receptors in prostate cancer and its bone metastases with Ga-68-DOTATOC PET/CT.
OBJECTIVE
To assess DOTATOC-affine somatostatin receptor expression in advanced prostate cancer and its bone metastases with regard to DOTATOC-mediated receptor therapies, using a Ga-68-DOTATOC PET/CT.


METHODS
Twenty consecutive patients with advanced prostate cancer underwent bone scintigraphy, followed by Ga-68-DOTATOC PET/CT within 3 weeks. Through side-by-side comparison with bone scintigraphy, the number of visible bone metastases on PET was determined. In addition, in cases of visible metastases, the maximum standard uptake value (SUV(max)) of Ga-68-DOTATOC was measured in the metastases and in normal bone. In patients who did not undergo a prostatectomy (n = 12), the SUV(max) was additionally measured in the prostate and in adjacent tissue. For focal lesions, the difference in SUV(max) (Delta SUV(max)) between the metastases and normal bone was calculated. For patients still having their prostate, a Delta SUV(max) between the prostate and its adjacent tissue was calculated.


RESULTS
Sixty four of 216 metastases (30%) were visible in 13 patients with focal metastases. Of six patients with diffuse metastases (superscan), one showed diffuse metastases, three showed a total of ten focal metastases, and two showed no correlate on PET. One patient with a neuroendocrine prostate cancer showed no correlate on PET. The maximum Delta SUV(max) between metastases and normal bone was 4.9 (mean = 1.6 +/- 0.9) and between the prostate and adjacent tissue 5.9 (mean = 2.8 +/- 1.6).


CONCLUSIONS
In prostate cancer and its bone metastases, DOTATOC-affine somatostatin receptors (subtype 2 and 5) can be visualized with Ga-68-DOTATOC PET/CT. But their expression is so weak that other conjugates should be tested for receptor-mediated therapies which are better at addressing the prostate cancer-specific somatostatin receptor subtypes 1 and 4-or even other receptors.
Luboldt
Wolfgang
W
Clinic and Policlinic of Nuclear Medicine, University Hospital Dresden, Dresden, Germany. wolfgang.luboldt@uniklinikum-dresden.de
Zöphel
Klaus
K
Wunderlich
Gerd
G
Abramyuk
Andrij
A
Luboldt
Hans-Joachim
HJ
Kotzerke
Joerg
J
D000368:Aged; D000369:Aged, 80 and over; D000728:Androgens; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D005710:Gallium Radioisotopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000031:analogs & derivatives*; D049268:Positron-Emission Tomography; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging*; D017481:Receptors, Somatostatin / Q000378:metabolism*; D014057:Tomography, X-Ray Computed
D000728:Androgens; D005710:Gallium Radioisotopes; D017481:Receptors, Somatostatin; D015282:Octreotide; C106246:Edotreotide