title: Multicenter comparison of 18F-FDG and 68Ga-DOTA-peptide PET/CT for pulmonary carcinoid.
abstract: OBJECTIVE
  The aims of this study were to retrospectively evaluate and compare the detection rate (DR) of 68Ga-DOTA-peptide and 18F-FDG PET/CT in the preoperative workup of patients with pulmonary carcinoid (PC) and to assess the utility of various functional indices obtained with the 2 tracers in predicting the histological characterization of PC, that is, typical versus atypical.
  
  
  METHODS
  Thirty-three consecutive patients with confirmed PC referred for 18F-FDG and 68Ga-DOTA-peptide PET/CT in 2 centers between January 2009 and April 2013 were included. The semiquantitative evaluation included the SUV max, the SUV of the tumor relative to the maximal liver uptake for 18F-FDG (SUV T/L) or the maximal spleen uptake for 68Ga-DOTA-peptides (SUV T/S), the ratio between SUV max of 68Ga-DOTA-peptides PET/CT, and the SUV max of 18F-FDG PET/CT (SUV max ratio). Histology was used as reference standard.
  
  
  RESULTS
  Definitive diagnosis consisted of 23 typical carcinoids (TCs) and 10 atypical carcinoids. 18F-FDG PET/CT was positive in 18 cases and negative in 15 (55% DR). 68Ga-DOTA-peptide PET/CT was positive in 26 cases and negative in 7 (79% DR). In the subgroup analysis, 68Ga-DOTA-peptide PET/CT was superior in detecting TC (91% DR; P < 0.001), whereas 18F-FDG PET/CT was superior in detecting atypical carcinoid (100% DR; P = 0.04). The SUV max ratio was the most accurate semiquantitative index in identifying TC.
  
  
  CONCLUSIONS
  Overall diagnostic performance of PET/CT in detecting PC is optimal when integrating 18F-FDG and 68Ga-DOTA-peptide PET/CT findings. In the subgroup analysis, the SUV max ratio seems to be the most accurate index in predicting TC. Both methods should be performed when PC is suspected or when the histological subtype is undefined.
authors.affiliation: From the *Unit of Thoracic Surgery, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia; †Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore; ‡Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo Forlanini; and §Institute of Hygiene, Università Cattolica del Sacro Cuore, Rome; ∥Department of Nuclear Medicine, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia; ¶Unit of Pathology, Azienda Ospedaliera San Camillo Forlanini, Rome; #Unit of Pathology, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia; **Department of Thoracic Surgery, and ††Institute of Pathology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Lococo
authors.forename: Germano
authors.initials: G
authors.lastname: Perotti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cardillo
authors.forename: Chiara
authors.initials: C
authors.lastname: De Waure
authors.forename: Angelina
authors.initials: A
authors.lastname: Filice
authors.forename: Paolo
authors.initials: P
authors.lastname: Graziano
authors.forename: Giulio
authors.initials: G
authors.lastname: Rossi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Sgarbi
authors.forename: Antonella
authors.initials: A
authors.lastname: Stefanelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giordano
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Granone
authors.forename: Guido
authors.initials: G
authors.lastname: Rindi
authors.forename: Annibale
authors.initials: A
authors.lastname: Versari
authors.forename: Vittoria
authors.initials: V
authors.lastname: Rufini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D015282:Octreotide / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D009942:Organometallic Compounds / Q000493:pharmacokinetics; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: C504894:68Ga-DOTANOC; C499142:Ga(III)-DOTATOC; D009942:Organometallic Compounds; D019788:Fluorodeoxyglucose F18; C513399:gallium Ga 68 dotatate; D015282:Octreotide