title: Impact of (68)Ga-DOTATATE PET/CT on the surgical management of primary neuroendocrine tumors of the pancreas or ileum.
abstract: BACKGROUND
  Resection is the only curative treatment in patients suffering from neuroendocrine tumors (NETs) of the ileum or the pancreas. Accurate preoperative imaging is critical for surgical planning, as even findings of small and distant metastases may profoundly influence surgical management.
  
  
  METHODS
  (68)Ga-DOTATATE PET/CT was performed preoperatively in 44 patients suffering from NET of the ileum (n = 26) or the pancreas (n = 18) before surgery at our University Hospital. Data were analyzed retrospectively by an interdisciplinary team of nuclear medicine and visceral surgery specialists. Intended surgical management was documented before and after availability of PET/CT findings. The team judged whether the imaging findings provided additional information relevant to surgical planning.
  
  
  RESULTS
  Imaging results altered surgical management in 9 of 44 (20 %) patients, more specifically in 3 of 26 (12 %) patients with NET of the ileum and in 6 of 18 (33 %) patients with NET of the pancreas. PET/CT findings led to a more invasive surgical approach in 6 cases (3 each of ileum and pancreas) and to a less invasive strategy in 3 patients with NET of the pancreas. Although PET/CT results did not alter management in 35 of 44 patients, somatostatin receptor imaging still provided additional information for surgery planning in more than 95 % of the cases.
  
  
  CONCLUSIONS
  Additional information provided by (68)Ga-DOTATATE PET/CT in the preoperative workup significantly influences surgical management in one-fifth of our NET patients and, notably, one-third of those suffering from NET of the pancreas.
authors.affiliation: Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Harun
authors.initials: H
authors.lastname: Ilhan
authors.forename: Wolfgang P
authors.initials: WP
authors.lastname: Fendler
authors.forename: Clemens C
authors.initials: CC
authors.lastname: Cyran
authors.forename: Christine
authors.initials: C
authors.lastname: Spitzweg
authors.forename: Christoph J
authors.initials: CJ
authors.lastname: Auernhammer
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Gildehaus
authors.forename: Peter
authors.initials: P
authors.lastname: Bartenstein
authors.forename: Martin K
authors.initials: MK
authors.lastname: Angele
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Haug
mesh_terms: D000328:Adult; D000368:Aged; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D005710:Gallium Radioisotopes; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000175:diagnosis*; D009942:Organometallic Compounds; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D005710:Gallium Radioisotopes; D009942:Organometallic Compounds; C513399:gallium Ga 68 dotatate