title: Role of (68)Ga-DOTATATE PET/CT in patients with multiple endocrine neoplasia type 1 (MEN1).
abstract: Multiple endocrine neoplasia type 1 (MEN1) is a hereditary syndrome predisposing to many endocrine and neuroendocrine tumors (NET). Conventional imaging (CI) cannot provide satisfactory results for all the different types of MEN1-related tumors. Objective of this prospective observational study was to evaluate the role of (68)Ga-DOTATATE PET/CT in MEN1 compared to CI. Diagnostic performance of (68)Ga-DOTATATE PET/CT for the detection of NET was evaluated as well as the prognostic role of SUVmax. Eighteen patients with genetically confirmed MEN1 were evaluated by (68)Ga-DOTATATE PET/CT, endoscopic ultrasounds, multidetector-row computed tomography, magnetic resonance imaging, and hormone/markers serum measurements. Four MEN1-related tumor sites (pancreas, pituitary, parathyroids, adrenals) were considered. Sensitivity and specificity of (68)Ga-DOTATATE PET/CT for the detection of NET were calculated. There was (68)Ga-DOTATATE PET/CT uptake in 11/11 patients with pancreatic lesions, in 9/12 with pituitary adenoma, in 5/15 with parathyroid enlargements, and in 5/7 with adrenal lesions. (68)Ga-DOTATATE PET/CT showed sensitivity and specificity of 100 and 100 % in pancreas, 75 and 83 % in pituitary, 28 and 100 % in parathyroids, and 62.5 and 100 % in adrenals, respectively. Compared with CI, no significant difference in sensitivity for pancreas, pituitary, and adrenals was found, while CI had a better sensitivity for parathyroids (p = 0.002). On the ROC analysis, progression of pancreatic lesions was significantly associated to SUVmax <12.3 (p < 0.05). (68)Ga-DOTATATE PET/CT is greatly helpful in the work-up of MEN1 providing a panoramic view of MEN1-related lesions. There is also a prognostic role of (68)Ga-PET in patients with MEN1-pancreatic lesions.
authors.affiliation: Division of Nuclear Medicine, Department of Diagnostic Imaging and Radiotherapy, Istituto Nazionale Tumori "Fondazione G.Pascale" - IRCCS Napoli, Naples, Italy. s.lastoria@istitutotumori.na.it.
authors.forename: Secondo
authors.initials: S
authors.lastname: Lastoria
authors.affiliation: Division of Endocrinology, Department of Clinical Medicine and Surgery, "Federico II" University of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy. francescamarciello81@gmail.com.
authors.forename: Francesca
authors.initials: F
authors.lastname: Marciello
authors.affiliation: Division of Endocrinology, Department of Clinical Medicine and Surgery, "Federico II" University of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy.
authors.forename: Antongiulio
authors.initials: A
authors.lastname: Faggiano
authors.affiliation: Division of Nuclear Medicine, Department of Diagnostic Imaging and Radiotherapy, Istituto Nazionale Tumori "Fondazione G.Pascale" - IRCCS Napoli, Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Aloj
authors.affiliation: Division of Nuclear Medicine, Department of Diagnostic Imaging and Radiotherapy, Istituto Nazionale Tumori "Fondazione G.Pascale" - IRCCS Napoli, Naples, Italy.
authors.forename: Corradina
authors.initials: C
authors.lastname: Caracò
authors.affiliation: Division of Nuclear Medicine, Department of Diagnostic Imaging and Radiotherapy, Istituto Nazionale Tumori "Fondazione G.Pascale" - IRCCS Napoli, Naples, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Aurilio
authors.affiliation: Division of Nuclear Medicine, Department of Diagnostic Imaging and Radiotherapy, Istituto Nazionale Tumori "Fondazione G.Pascale" - IRCCS Napoli, Naples, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: D'Ambrosio
authors.affiliation: Division of Nuclear Medicine, Department of Diagnostic Imaging and Radiotherapy, Istituto Nazionale Tumori "Fondazione G.Pascale" - IRCCS Napoli, Naples, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Di Gennaro
authors.affiliation: Division of Endocrinology, Department of Clinical Medicine and Surgery, "Federico II" University of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Ramundo
authors.affiliation: Department of Biomorphological and Functional Sciences, "Federico II" University of Napoli, Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Camera
authors.affiliation: Gastrointestinal Unit, "Pellegrini Hospital", Naples, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: De Luca
authors.affiliation: Istitute of Biostructures and Bioimages (IBB), National Research Council, Naples, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Fonti
authors.affiliation: Department of General and Specialistic Surgery, Second University of Napoli, Caserta, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Napolitano
authors.affiliation: Division of Endocrinology, Department of Clinical Medicine and Surgery, "Federico II" University of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000000981:diagnostic imaging*; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging*; D009942:Organometallic Compounds; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D009942:Organometallic Compounds; C513399:gallium Ga 68 dotatate
keywords: 68Ga-DOTATATE PET/CT; Hyperparathyroidism; MEN1; Neuroendocrine tumor; Pituitary adenoma