title: The role of 68Ga-DOTA-NOC PET/CT in evaluating neuroendocrine tumors: real-world experience from two large neuroendocrine tumor centers.
abstract: OBJECTIVE
  Our aim was to assess the role of Ga-DOTA-NOC PET/CT as a tool for the management of neuroendocrine tumors (NETs), evaluating the clinical impact on patients from two large NET centers in different geopolitical settings.
  
  
  METHODS
  This is a retrospective study of patients with NETs who underwent Ga-DOTA-NOC PET/CT at Royal Liverpool University Hospital (UK) and at Mount Lebanon Hospital (Lebanon). Indications for imaging and findings of the PET/CT along with demographic and clinical outcome data were recorded and evaluated.
  
  
  RESULTS
  Four hundred and forty-five patients fulfilled the inclusion criteria, with a median age at the time of diagnosis of 56 (range: 3-90) years; 248 (55.7%) patients were male.Ga-DOTA-NOC PET/CT was indicated for staging in 193 (43.4%) patients, for diagnosis in 124 (27.9%) patients, for follow-up in 97 (21.7%) patients, and for identification of a primary NET site in 31 (7%) patients.One hundred and four (27.9%) patients underwent Ga-DOTA-NOC PET/CT for the primary diagnosis of NET, of whom 66 (52.7%) patients presented with a clinical suspicion of NET, 10 (8.3%) patients presented with a biochemical suspicion of NET only, and 48 (38.8%) patients presented with a suspicious NET lesion discovered on another imaging modality. The most common clinical presentation was typical carcinoid syndrome [4 (33%) patients].Results on the basis of histology were used as the gold standard for the diagnosis in 57% of patients and the remaining on the basis of follow-up as per established clinical consensus. Sensitivity, specificity, negative-predictive value, and positive-predictive value of PET/CT were 87.1, 97.7, 79.6, and 98.7%, respectively, for the entire sample. Accuracy was measured using the receiver operating characteristic curve analysis with an area under the curve of 0.924 (95% confidence interval: 0.874-0.974).
  
  
  CONCLUSIONS
  Ga-DOTA-NOC PET/CT is a highly sensitive and specific study for the diagnosis and follow-up of patients with neuroendocrine tumors. These results support the use of Ga-DOTA-NOC PET/CT contributing significantly toward the clinical management of NET patients.
authors.affiliation: aDepartment of Nuclear Medicine, Royal Liverpool University Hospital, Liverpool, UK Departments of bRadiology cInternal Medicine, American University of Beirut dDepartment of Nuclear Medicine, Mount Lebanon Hospital eDepartment of Internal Medicine, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Haidar
authors.forename: Ali
authors.initials: A
authors.lastname: Shamseddine
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Panagiotidis
authors.forename: Mario
authors.initials: M
authors.lastname: Jreige
authors.forename: Deborah
authors.initials: D
authors.lastname: Mukherji
authors.forename: Rita
authors.initials: R
authors.lastname: Assi
authors.forename: Rayan
authors.initials: R
authors.lastname: Abousaid
authors.forename: Toni
authors.initials: T
authors.lastname: Ibrahim
authors.forename: Marwan M
authors.initials: MM
authors.lastname: Haddad
authors.forename: Sobhan
authors.initials: S
authors.lastname: Vinjamuri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057054:Molecular Imaging / Q000379:methods / Q000706:statistics & numerical data; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D009942:Organometallic Compounds; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods* / Q000706:statistics & numerical data; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: C504894:68Ga-DOTANOC; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals