title: The Impact of Somatostatin Receptor-Directed PET/CT on the Management of Patients with Neuroendocrine Tumor: A Systematic Review and Meta-Analysis.
abstract: Somatostatin receptor (SSTR) imaging is widely used for guiding the management of neuroendocrine tumor (NET) patients.68Ga-DOTATATE approval by the U.S. Food and Drug Administration has triggered widespread clinical interest in SSTR PET/CT throughout the United States. Here, we performed a systematic review and meta-analysis to evaluate the impact of SSTR PET/CT on the management of patients with NETs.Methods:A comprehensive literature search was performed using The National Center for Biotechnology Information PubMed online database, applying the following key words: "management" AND "PET" AND "neuroendocrine". Fourteen of 190 studies were deemed suitable based on the following inclusion criteria: original research, cohort study, number of patients 10 or more, and reported change in management after SSTR PET/CT. Change in management across studies was determined by a random-effects model.Results:A total of 1,561 patients were included. Overall, change in management occurred in 44% (range, 16%-71%) of NET patients after SSTR PET/CT. In 4 of 14 studies, SSTR PET/CT was performed after an111In-Octreotide scan. In this subgroup, additional information by SSTR PET/CT led to a change in management in 39% (range, 16%-71%) of patients. Seven of 14 studies differentiated between inter- and intramodality changes, with most changes being intermodality (77%; intramodality, 23%).Conclusion:The management was changed in more than one third of patients undergoing SSTR PET/CT even when performed after an111In-Octreotide scan. Intermodality changes were 3 times more likely than intramodality changes, underlining the clinical impact of SSTR PET/CT.
authors.affiliation: Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Martin
authors.initials: M
authors.lastname: Barrio
authors.affiliation: Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Johannes
authors.initials: J
authors.lastname: Czernin
authors.affiliation: Nuclear Medicine Unit, University of Bologna, S. Orsola Hospital Bologna, Bologna, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Fanti
authors.affiliation: Nuclear Medicine Unit, University of Bologna, S. Orsola Hospital Bologna, Bologna, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Ambrosini
authors.affiliation: Department of Nuclear Medicine, University Hospital Essen, Essen, Germany.
authors.forename: Ina
authors.initials: I
authors.lastname: Binse
authors.affiliation: Department of Biostatistics, David Geffen School of Medicine at UCLA, Los Angeles, California; and.
authors.forename: Lin
authors.initials: L
authors.lastname: Du
authors.affiliation: Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Matthias
authors.initials: M
authors.lastname: Eiber
authors.affiliation: Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California kherrmann@mednet.ucla.edu.|Department of Nuclear Medicine, University Hospital Essen, Essen, Germany.
authors.forename: Ken
authors.initials: K
authors.lastname: Herrmann
authors.affiliation: Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, California.|Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Wolfgang P
authors.initials: WP
authors.lastname: Fendler
mesh_terms: D006801:Humans; D057054:Molecular Imaging / Q000706:statistics & numerical data; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000628:therapy*; D009942:Organometallic Compounds / Q000493:pharmacokinetics*; D010346:Patient Care Management / Q000706:statistics & numerical data*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods / Q000706:statistics & numerical data*; D015995:Prevalence; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D017481:Receptors, Somatostatin / Q000378:metabolism*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin; C513399:gallium Ga 68 dotatate
keywords: DOTATATE; DOTATOC; GI; PET/CT; SSTR; management; neuroendocrine; oncology; peptides