title: 68Gallium DOTANOC-PET Imaging in Lung Carcinoids: Impact on Patients' Management.
abstract: 68Gallium DOTA-PET imaging is preferable to standard somatostatin receptor scintigraphy where available; however, its role in the management of lung carcinoid tumours (LC) remains unclear.
  
  
  
  All consecutive patients with histologically confirmed LC from two ENETS Centres of Excellence were identified retrospectively. The primary objective was to assess the impact of 68Ga-DOTANOC-PET on clinical management in patients with LC.
  
  
  
  Of 166 patients screened, 46 were eligible: 52% female, median age 57 years (range 21-86); type of LC: diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (4%), typical (44%), atypical (35%), not reported (17%); stage: localised (63%), locally advanced (13%), and metastatic (17%) (7% unknown). A total of 47 68Ga-DOTANOCs were performed with the following rationale: LC diagnosis confirmation (4; 9%), primary tumour identification (2; 4%), post-surgical assessment (19; 40%), staging (patients with known LC present at time of 68Ga-DOTANOC) (19; 40%), and consideration of peptide receptor radionuclide therapy (3; 7%). Twenty-seven (57%) scans showed evidence of non-physiological uptake: median maximum standardised uptake value 7.2 (range 1.42-53). 68Ga-DOTANOC provided additional information in 37% (95% CI 22-51) of patients and impacted on management in 26% (95% CI 12-41); 9 patients (21%) were identified to have occult sites of metastases. Out of the 19 patients with post-surgical 68Ga-DOTANOC, 3 (16%) were identified to have distant metastases. There were no differences in the rate of practice changing 68Ga-DOTANOC results by type of LC (p value 0.5).
  
  
  
  Our results support the role of 68Ga-DOTANOC for optimising the management of patients with LC, including post-surgical re-staging due to the potential for identifying occult metastases.
authors.forename: Angela
authors.initials: A
authors.lastname: Lamarca
authors.forename: D Mark
authors.initials: DM
authors.lastname: Pritchard
authors.forename: Thomas
authors.initials: T
authors.lastname: Westwood
authors.forename: Georgios
authors.initials: G
authors.lastname: Papaxoinis
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nonaka
authors.forename: Sobhan
authors.initials: S
authors.lastname: Vinjamuri
authors.forename: Juan W
authors.initials: JW
authors.lastname: Valle
authors.forename: Prakash
authors.initials: P
authors.lastname: Manoharan
authors.forename: Wasat
authors.initials: W
authors.lastname: Mansoor
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000601:surgery; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging; D009942:Organometallic Compounds; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: C504894:68Ga-DOTANOC; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals
keywords: DOTANOC; Gallium; Lung; Lung carcinoid; Neuroendocrine tumour; Positron emission tomography