Gallium-68-DOTA-NOC PET/CT of patients with gastroenteropancreatic neuroendocrine tumors: a prospective single-center study.
OBJECTIVE
The objective of this study was to evaluate the role of (68)Ga-labeled [1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid]-1-NaI(3)-octreotide (DOTA-NOC) PET/CT in the diagnosis and management of gastroenteropancreatic neuroendocrine tumors (NETs).


METHODS
One hundred nine patients (median age, 50 years) with gastroenteropancreatic NETs underwent (68)Ga-DOTA-NOC PET/CT. PET/CT was performed after injection of 132-222 MBq (4-6 mCi) of (68)Ga-DOTA-NOC. Images were evaluated by two experienced nuclear medicine physicians both qualitatively as well as quantitatively (maximum standardized uptake value [SUV(max)]). Results of PET/CT were compared with the results of conventional imaging. Histopathology results, when available, and follow-up PET/CT or conventional imaging with biochemical markers were considered to be the reference standards.


RESULTS
Gallium-68-DOTA-NOC PET/CT showed sensitivity and specificity of 78.3% and 92.5%, respectively, for primary tumor and 97.4% and 100% for metastases. It was better than a conventional imaging modality for the detection of both primary tumor (p < 0.001) and metastases (p < 0.0001). It changed the management strategy in 21 patients (19%) and supported management decisions in 32 patients (29%).


CONCLUSIONS
Gallium-68-DOTA-NOC PET/CT appears to be a highly sensitive and specific modality for the detection of gastroenteropancreatic NET. It is better than conventional imaging for the evaluation of gastroenteropancreatic NETs and can have a significant impact on patient management.
Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Niraj
N
Naswa
Punit
P
Sharma
Abhishek
A
Kumar
Aftab Hasan
AH
Nazar
Rakesh
R
Kumar
Sunil
S
Chumber
Chandrashekhar
C
Bal
D005260:Female; D005710:Gallium Radioisotopes; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging*; D009942:Organometallic Compounds; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
C504894:68Ga-DOTANOC; D005710:Gallium Radioisotopes; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals