title: Clinical value of ⁶⁸Ga-DOTATATE-PET/CT compared to stand-alone contrast enhanced CT for the detection of extra-hepatic metastases in patients with neuroendocrine tumours (NET).
abstract: OBJECTIVE
  To compare and outline the beneficial skills of combined (68)Ga-DOTATATE positron emission tomography (PET) with concurrent contrast enhanced X-ray computed tomography (ceCT) against stand-alone ceCT in 54 patients with neuroendocrine tumours (NET).
  
  
  METHODS
  Patients with histologically confirmed NET and available follow-up of at least 6 months (median 12.6 months; range 6.1-23.2) were included. PET/CT and ceCT images were initially analyzed separately by two blinded nuclear medicine physicians and two radiologists, respectively. In a second step all four physicians reviewed all detected lesions together reaching a consensus-grading for PET/ceCT. The results were then compared to the reference standard consisting of clinical follow-up data.
  
  
  RESULTS
  With regard to true positive lesions, PET/ceCT vs. stand alone ceCT detected 139 vs. 48 bone-lesions, 106 vs. 71 lymph node metastases and 26 vs. 26 pulmonary lesions. On a per-patient basis, PET/ceCT achieved a higher sensitivity (100% vs. 47%) and specificity (89% vs. 49%) for bone lesions than ceCT. For lymph nodes the effect was similar (sensitivity 92% vs. 64% and specificity 83% vs. 59%). For the detection of pulmonary lesions the sensitivity was identical (100%) while specificity of PET/ceCT was superior to ceCT-alone (95% vs. 82%).
  
  
  CONCLUSIONS
  In summary, the use of (68)Ga-DOTATATE PET/ceCT leads to an increase in sensitivity and specificity in the detection of extra-hepatic NET metastases compared to stand-alone ceCT. Therefore, (68)Ga-DOTATATE PET/ceCT should be the imaging modality of choice in patients with NET.
authors.affiliation: Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
authors.forename: D R
authors.initials: DR
authors.lastname: Albanus
authors.affiliation: Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; Department of Diagnostic and Interventional Radiology, University of Gießen and Marburg, Baldingerstraße, 35043 Marburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Apitzsch
authors.affiliation: Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; Department of Radiology, Medical Faculty of Bulent Ecevit University, Practice and Research Hospital of Bulent Ecevit University; 67600, Kozlu, Esenköy, Zongludak, Turkey.
authors.forename: Z
authors.initials: Z
authors.lastname: Erdem
authors.affiliation: Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; Department of Radiology, Medical Faculty of Bulent Ecevit University, Practice and Research Hospital of Bulent Ecevit University; 67600, Kozlu, Esenköy, Zongludak, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Erdem
authors.affiliation: Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
authors.forename: F A
authors.initials: FA
authors.lastname: Verburg
authors.affiliation: Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
authors.forename: F F
authors.initials: FF
authors.lastname: Behrendt
authors.affiliation: Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
authors.forename: F M
authors.initials: FM
authors.lastname: Mottaghy
authors.affiliation: Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; Institute of Neuroscience and Medicine (INM4), Research Centre Jülich, Germany. Electronic address: aheinzel@ukaachen.de.
authors.forename: A
authors.initials: A
authors.lastname: Heinzel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000556:secondary; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods / Q000706:statistics & numerical data; D008113:Liver Neoplasms / Q000175:diagnosis*; D008175:Lung Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods* / Q000706:statistics & numerical data; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000175:diagnosis* / Q000556:secondary; D009942:Organometallic Compounds / Q000008:administration & dosage*; D049268:Positron-Emission Tomography / Q000379:methods* / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D012015:Reference Standards; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000706:statistics & numerical data; D051598:Whole Body Imaging / Q000379:methods / Q000706:statistics & numerical data
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C513399:gallium Ga 68 dotatate
keywords: (68)Ga-DOTA-TATE; Extra-hepatic metastasis; Neuroendocrine tumour; PET/CT