title: Impact of 68Ga-DOTATATE PET/CT on the management of neuroendocrine tumors: the referring physician's perspective.
abstract: Somatostatin receptor imaging with (68)Ga-DOTATATE PET/CT (DOTATATE) is increasingly used for managing patients with neuroendocrine tumors. The objective of this study was to determine referring physicians' perspectives on the impact of DOTATATE on the management of neuroendocrine tumors.
  
  
  METHODS
  A set of 2 questionnaires (pre-PET and post-PET) was sent to the referring physicians of 100 consecutive patients with known or suspected neuroendocrine tumors, who were evaluated with DOTATATE. Questionnaires on 88 patients were returned (response rate, 88%). Referring physicians categorized the DOTATATE findings on the basis of the written PET reports as negative, positive, or equivocal for disease. The likelihood for metastatic disease was scored as low, moderate, or high. The intended management before and changes as a consequence of the PET study were indicated.
  
  
  RESULTS
  The indications for PET/CT were initial and subsequent treatment strategy assessments in 14% and 86% of patients, respectively. Referring physicians reported that DOTATATE led to a change in suspicion for metastatic disease in 21 patients (24%; increased and decreased suspicion in 9 [10%] and 12 [14%] patients, respectively). Intended management changes were reported in 53 of 88 (60%) patients. Twenty patients (23%) scheduled to undergo chemotherapy were switched to treatments without chemotherapy, and 6 (7%) were switched from watch-and-wait to other treatment strategies. Conversely, 5 patients (6%) were switched from their initial treatment strategy to watch-and-wait.
  
  
  CONCLUSIONS
  This survey of referring physicians demonstrates a substantial impact of DOTATATE on the intended management of patients with neuroendocrine tumors.
authors.affiliation: Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
authors.forename: Ken
authors.initials: K
authors.lastname: Herrmann
authors.affiliation: Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Johannes
authors.initials: J
authors.lastname: Czernin
authors.affiliation: Carcinoid/Neuroendocrine Tumor Program, Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, California; and.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Wolin
authors.affiliation: Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Pawan
authors.initials: P
authors.lastname: Gupta
authors.affiliation: Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Martin
authors.initials: M
authors.lastname: Barrio
authors.affiliation: Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gutierrez
authors.affiliation: Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Christiaan
authors.initials: C
authors.lastname: Schiepers
authors.affiliation: Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Sherly
authors.initials: S
authors.lastname: Mosessian
authors.affiliation: Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Phelps
authors.affiliation: Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California mauerbach@mednet.ucla.edu.
authors.forename: Martin S
authors.initials: MS
authors.lastname: Allen-Auerbach
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009362:Neoplasm Metastasis; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D009942:Organometallic Compounds; D010820:Physicians; D049268:Positron-Emission Tomography; D012017:Referral and Consultation; D058028:Research Report; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed
chemical_list: D009942:Organometallic Compounds; C513399:gallium Ga 68 dotatate
keywords: DOTATATE; NET; PET; neuroendocrine tumors; somatostatin receptor