title: Head-to-Head Comparison of64Cu-DOTATATE and68Ga-DOTATOC PET/CT: A Prospective Study of 59 Patients with Neuroendocrine Tumors.
abstract: Somatostatin receptor imaging is a valuable tool in the diagnosis, follow-up, and treatment planning of neuroendocrine tumor (NET). PET-based tracers using68Ga as the radioisotope have in most centers replaced SPECT-based tracers as the gold standard.64Cu-DOTATATE is a new PET tracer that has been shown to be far superior to the SPECT tracer111In-diethylenetriaminepentaacetic acid-octreotide. Because of the advantages of64Cu over68Ga, we hypothesized that the tracer has a higher sensitivity than68Ga-based tracers. To test this hypothesis, we compared on a head-to-head basis the diagnostic performance of64Cu-DOTATATE with that of68Ga-DOTATOC in NET patients.Methods:Fifty-nine NET patients were scanned with both64Cu-DOTATATE and68Ga-DOTATOC PET/CT and compared on a head-to-head basis. Discordant lesions were verified during at least 30 mo of follow-up.Results:A total of 701 lesions were concordantly detected on both64Cu-DOTATATE and68Ga-DOTATOC PET/CT scans, whereas an additional 68 lesions were found by only one of the scans.64Cu-DOTATATE showed 42 lesions not found on68Ga-DOTATOC, of which 33 were found to be true-positive on follow-up.68Ga-DOTATOC showed 26 lesions not found on64Cu-DOTATATE, of which 7 were found to be true-positive on follow-up. False-positives were mainly lymph node lesions. Accordingly, 83% of the additional true lesions found on only one of the scans were found by64Cu-DOTATATE. On a patient-basis, additional true lesions were found by64Cu-DOTATATE and68Ga-DOTATOC in 13 and 3 patients, respectively. All patients with additional lesions also had concordant lesions found by both scans.Conclusion:64Cu-DOTATATE has advantages over68Ga-DOTATOC in the detection of lesions in NET patients. Although patient-based sensitivity was the same for64Cu-DOTATATE and68Ga-DOTATOC in this cohort, significantly more lesions were detected by64Cu-DOTATATE. Furthermore, the shelf life of more than 24 h and the scanning window of at least 3 h make64Cu-DOTATATE favorable and easy to use in the clinical setting.
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.|ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Camilla B
authors.initials: CB
authors.lastname: Johnbeck
authors.affiliation: ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark.|Department of Surgical Gastroenterology and Department of Clinical Endocrinology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Knigge
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.|ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Annika
authors.initials: A
authors.lastname: Loft
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.|ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Anne K
authors.initials: AK
authors.lastname: Berthelsen
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.|ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Jann
authors.initials: J
authors.lastname: Mortensen
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.|ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Oturai
authors.affiliation: ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark.|Department of Oncology, Rigshospitalet, Copenhagen, Denmark; and.
authors.forename: Seppo W
authors.initials: SW
authors.lastname: Langer
authors.affiliation: Hevesy Laboratory, DTU Nutech, Technical University of Denmark, Roskilde, Denmark.
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Elema
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark akjaer@sund.ku.dk.|ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kjaer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000473:pathology; D015588:Observer Variation; D015282:Octreotide / Q000031:analogs & derivatives*; D009942:Organometallic Compounds; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: C575629:64Cu-DOTATATE; C499142:Ga(III)-DOTATOC; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; D015282:Octreotide
keywords: 64Cu-DOTATATE; 68Ga-DOTATOC; PET/CT; neuroendocrine tumors; somatostatin receptor imaging