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Management Impact of 68Ga-DOTATATE PET/CT in Neuroendocrine Tumors
Redmond-Craig Anderson,Erik M. Velez,Bhushan Desai,Hossein Jadvar 대한핵의학회 2021 핵의학 분자영상 Vol.55 No.1
Purpose The goal of our retrospective single tertiary academic medical center investigation was to examine the added diagnostic value and clinical impact of 68Ga-DOTATATE PET/CT in the therapeutic management of patients with neuroendocrine tumors (NETs). Methods Imaging database was queried for all “PET-DOTATATE” examinations performed at our tertiary care academic institution usingMONTAGE™. The patient’s clinical history and recent prior imaging were reviewed. The additional diagnostic value and clinical management impact of 68Ga-DOTATATE were assessed through retrospective chart review. Results A total of 81 68Ga-DOTATATE PET/CT scans in 74 patients were found, and 11 patientswere excluded fromanalysis as they had no prior imaging available for comparison, with resultant analysis cohort of 63 patients. Six patients had 2 ormore 68Ga- DOTATATE PET/CT examinations. The most common primary diagnosis was undifferentiated NET (63.5%), followed by carcinoid (27.0%), paraganglioma (4.8%), insulinoma (3.2%), and pheochromocytoma (1.6%). The primary sites of disease from the most to the least common were the pancreas (36.5%), small bowel (22.2%), unknown primary (15.9%), lung (6.3%), large bowel (6.3%), and mesentery (4.8%), and other locations accounted for 7.9%. In patients who had prior imaging available for comparison, there were new lesions identified on 68Ga-DOTATATE PET/CT in 21 patients (33.3%) that were not identified on other prior imaging modalities. Of these patients, 5 underwent subsequentMRI and 1 had a repeat 68Ga-DOTATATE PET/CT to further characterize new lesions seen. Moreover, 15 patients (23.8%) had a change in treatment plan, including altering medical therapy in 9 patients, change in planned extent of surgical management in 5 patients, and cancelation of a planned primary tumor resection in 1 patient with metastatic disease. Conclusion Our retrospective cohort demonstrated that 68Ga-DOTATATE PET/CT improves lesion detection over conventional imaging in 33.3% and impacts the therapeutic management in 23.8% of patients with NET.