title: Evaluation of (68)Ga-DOTA-TOC PET/CT for the detection of duodenopancreatic neuroendocrine tumors in patients with MEN1.
abstract: BACKGROUND
  Somatostatin receptor scintigraphy with (111)In-pentetreotide (SRS) is used to detect duodenopancreatic neuroendocrine tumors (dpNETs) in multiple endocrine neoplasia type 1 (MEN1). However, SRS has limited sensitivity for this purpose. Positron emission tomography/computed tomography (PET/CT) with (68)Ga-DOTA-TOC has a higher rate of sporadic dpNETs detection than SRS but there is little data for dpNETs detection in MEN1.
  
  
  OBJECTIVE
  To compare the performances of (68)Ga-DOTA-TOC PET/CT, SRS and contrast-enhanced computed tomography (CE-CT) to diagnose dpNETs in MEN1.
  
  
  METHODS
  Single-institution prospective comparative study
  
  
  METHODS
  Nineteen consecutive MEN1 patients (aged 47 ± 13 years) underwent (68)Ga-DOTA-TOC PET/CT, SRS, and CE-CT within 2 months in random order. Blinded readings of images were performed separately by experienced physicians. Unblinded analysis of CE-CT, combined with additional magnetic resonance imaging, endoscopic-ultrasound, (18)F-2-fluoro-deoxy-D-glucose ((18)F-FDG) PET/CT or histopathology results served as reference standard for dpNETs diagnosis.
  
  
  RESULTS
  The sensitivity of (68)Ga-DOTA-TOC PET/CT, SRS, and CE-CT was 76, 20, and 60 %, respectively (p < 0.0001). All the true-positive lesions detected by SRS were also depicted on (68)Ga-DOTA-TOC PET/CT. (68)Ga-DOTA-TOC PET/CT detected lesions of smaller size than SRS (10.7 ± 7.6 and 15.2 ± 5.9 mm, respectively, p < 0.03). False negatives of (68)Ga-DOTA-TOC PET/CT included small dpNETs (<10 mm) and (18)F-FDG PET/CT positive aggressive dpNETs. No false positives were recorded. In addition, whole-body mapping with (68)Ga-DOTA-TOC PET/CT identified extra-abdominal MEN1-related tumors including one neuroendocrine thymic carcinoma identified by the three imaging procedures, one bronchial carcinoid undetected by CE-CT and three meningiomas undetected by SRS.
  
  
  CONCLUSIONS
  Owing to higher diagnostic performance, (68)Ga-DOTA-TOC PET/CT (or alternative (68)Ga-labeled somatostatin analogues) should replace (111)In-pentetreotide in the investigation of MEN1 patients.
authors.affiliation: CNRS, INCIA, UMR 5287, 33000, Bordeaux, France. clement.morgat@chu-bordeaux.fr.|University of Bordeaux, INCIA, UMR 5287, 33000, Bordeaux, France. clement.morgat@chu-bordeaux.fr.|Department of Nuclear Medicine, University Hospital of Bordeaux, 33000, Bordeaux, France. clement.morgat@chu-bordeaux.fr.
authors.forename: Clément
authors.initials: C
authors.lastname: Morgat
authors.affiliation: Department of Endocrinology, USN Haut-Lévêque, 33604, Pessac, France.
authors.forename: Fritz-Line
authors.initials: FL
authors.lastname: Vélayoudom-Céphise
authors.affiliation: Department of Nuclear Medicine, University Hospital of Bordeaux, 33000, Bordeaux, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Schwartz
authors.affiliation: Department of Nuclear Medicine, University Hospital of Bordeaux, 33000, Bordeaux, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Guyot
authors.affiliation: Department of Radiology, University Hospital of Bordeaux, 33604, Pessac, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Gaye
authors.affiliation: CNRS, INCIA, UMR 5287, 33000, Bordeaux, France.|University of Bordeaux, INCIA, UMR 5287, 33000, Bordeaux, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Vimont
authors.affiliation: CNRS, INCIA, UMR 5287, 33000, Bordeaux, France.|University of Bordeaux, INCIA, UMR 5287, 33000, Bordeaux, France.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Schulz
authors.affiliation: CNRS, INCIA, UMR 5287, 33000, Bordeaux, France.|University of Bordeaux, INCIA, UMR 5287, 33000, Bordeaux, France.|Department of Nuclear Medicine, University Hospital of Bordeaux, 33000, Bordeaux, France.
authors.forename: Joachim
authors.initials: J
authors.lastname: Mazère
authors.affiliation: Department of Endocrinology, USN Haut-Lévêque, 33604, Pessac, France.
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Nunes
authors.affiliation: Department of Oncology, University Hospital of Bordeaux, 33000, Bordeaux, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Smith
authors.affiliation: CNRS, INCIA, UMR 5287, 33000, Bordeaux, France.|University of Bordeaux, INCIA, UMR 5287, 33000, Bordeaux, France.|Department of Nuclear Medicine, University Hospital of Bordeaux, 33000, Bordeaux, France.
authors.forename: Elif
authors.initials: E
authors.lastname: Hindié
authors.affiliation: CNRS, INCIA, UMR 5287, 33000, Bordeaux, France.|University of Bordeaux, INCIA, UMR 5287, 33000, Bordeaux, France.|Department of Nuclear Medicine, University Hospital of Bordeaux, 33000, Bordeaux, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Fernandez
authors.affiliation: Department of Endocrinology, USN Haut-Lévêque, 33604, Pessac, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Tabarin
mesh_terms: D000328:Adult; D000368:Aged; D004386:Duodenum; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000150:complications*; D018358:Neuroendocrine Tumors / Q000150:complications* / Q000000981:diagnostic imaging*; D015282:Octreotide / Q000031:analogs & derivatives*; D009942:Organometallic Compounds; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging*; D000072078:Positron Emission Tomography Computed Tomography
chemical_list: C499142:Ga(III)-DOTATOC; D009942:Organometallic Compounds; D015282:Octreotide
keywords: 111In-pentetreotide SPECT/CT; 68Ga-DOTA-TOC PET/CT; Contrast-enhanced computed tomography; Duodenopancreatic neuroendocrine tumors; Multiple endocrine neoplasia type 1
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