title: The Impact of 68Ga-DOTATATE PET/CT Imaging on Management of Patients with Neuroendocrine Tumors: Experience from a National Referral Center in the United Kingdom.
abstract: (68)Ga-DOTATATE PET/CT scanning is a widely accepted method for imaging of neuroendocrine tumors. This cross-sectional study was performed to review the first 8 y of patient data from a large (68)Ga-DOTATATE PET/CT database in order to establish the impact of the modality on patient treatment and survival.
  
  
  METHODS
  Demographic data, clinical outcome, survival, and change in management after (68)Ga-DOTATATE PET/CT were evaluated.
  
  
  RESULTS
  Between May 2005 and August 2013, 1,258 (68)Ga-DOTATATE PET/CT scans were obtained in 728 patients with confirmed or suspected neuroendocrine tumors. In most patients, the primary site was located in the midgut (26.4%). Analysis of NET grading in patients with known histopathologic data revealed that 35.7% had NET grade G1, 12.2% G2, and 8.7% G3. The most common indications for (68)Ga-DOTATATE PET/CT were follow-up (24.4%) and initial tumor staging (23.4%). Of the 1,258 (68)Ga-DOTATATE PET/CT scans completed, 75.7% were positive and 24.3% negative; there were 14 false-positive and 29 false-negative scans. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 97%, 95.1%, 96.6%, 98.5%, and 90.4%, respectively. In 40.9% of patients, the treatment plan was changed after the scans, owing mainly to new, unexpected findings. Statistically significant differences in survival were shown between patients with G1, G2, and G3 grade tumors (P < 0.0001) and also between patients with bone metastasis versus patients with soft-tissue metastasis (P < 0.0001).
  
  
  CONCLUSIONS
  (68)Ga-DOTATATE PET/CT scanning is safe and influences management in a large proportion of patients. Prognosis was dependent on tumor grade, and the presence of bone metastasis was associated with worse overall survival.
authors.affiliation: Nuclear Medicine Department, University College Hospital, London, United Kingdom.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Skoura
authors.affiliation: Nuclear Medicine Department, University College Hospital, London, United Kingdom.
authors.forename: Sofia
authors.initials: S
authors.lastname: Michopoulou
authors.affiliation: Neuroendocrine Tumour Unit, Royal Free Hospital, London, United Kingdom; and.
authors.forename: Mullan
authors.initials: M
authors.lastname: Mohmaduvesh
authors.affiliation: Nuclear Medicine Department, University College Hospital, London, United Kingdom.
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Panagiotidis
authors.affiliation: Nuclear Medicine Department, University College Hospital, London, United Kingdom.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al Harbi
authors.affiliation: Neuroendocrine Tumour Unit, Royal Free Hospital, London, United Kingdom; and.
authors.forename: Christos
authors.initials: C
authors.lastname: Toumpanakis
authors.affiliation: Nuclear Medicine Department, University College Hospital, London, United Kingdom.
authors.forename: Omar
authors.initials: O
authors.lastname: Almukhailed
authors.affiliation: Nuclear Medicine Department, University College Hospital, London, United Kingdom.
authors.forename: Irfan
authors.initials: I
authors.lastname: Kayani
authors.affiliation: Nuclear Medicine Department, University College Hospital, London, United Kingdom.
authors.forename: Rizwan
authors.initials: R
authors.lastname: Syed
authors.affiliation: Nuclear Medicine Department, Royal Free Hospital, London, United Kingdom.
authors.forename: Shaunak
authors.initials: S
authors.lastname: Navalkissoor
authors.affiliation: Nuclear Medicine Department, University College Hospital, London, United Kingdom.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Ell
authors.affiliation: Neuroendocrine Tumour Unit, Royal Free Hospital, London, United Kingdom; and.
authors.forename: Martyn E
authors.initials: ME
authors.lastname: Caplin
authors.affiliation: Nuclear Medicine Department, University College Hospital, London, United Kingdom jamshed.bomanji@uclh.nhs.uk.
authors.forename: Jamshed
authors.initials: J
authors.lastname: Bomanji
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009362:Neoplasm Metastasis; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D009942:Organometallic Compounds; D049268:Positron-Emission Tomography; D012017:Referral and Consultation; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D006113:United Kingdom; D055815:Young Adult
chemical_list: D009942:Organometallic Compounds; C513399:gallium Ga 68 dotatate
keywords: 68Ga-DOTATATE; PET/CT; neuroendocrine tumors; somatostatin receptor imaging