Document Detail


The impact of 68Ga-DOTATOC positron emission tomography/computed tomography on the multimodal management of patients with neuroendocrine tumors.
MedLine Citation:
PMID:  21037441     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the impact of 68Ga-DOTATOC positron emission tomography (PET)/computed tomography (CT) on the multimodal management of neuroendocrine tumors (NET).
BACKGROUND: Establishment of the extent and progression of NET are necessary to decide which treatment option to choose. However, morphological imaging with CT or magnetic resonance imaging (MRI) is often inadequate in identifying the primary tumor and/or in detecting small metastatic lesions.
METHODS: In total, 52 patients (27 women and 25 men) with histologically proven NET could be included in the protocol of comparison between 68Ga-DOTATOC PET/CT and CT and/or MRI. The examinations were performed in terms of tumor staging and, in some instances, also of primary tumor site identification to evaluate the patient's eligibility for treatment. Each patient presented with either CT and/or MRI performed elsewhere and consecutively underwent 68Ga-DOTATOC PET/CT in our institution.
RESULTS: In all 52 patients, 68Ga-DOTATOC PET/CT demonstrated pathologically increased uptake for at least 1 tumor site, yielding a sensitivity of 100% on a patient basis. In 3 of 4 patients with unknown primary tumor site, 68Ga-DOTATOC PET/CT visualized the primary tumor region (jejunum, ileum, and pancreas, respectively) not identified on CT and/or MRI. 68Ga-DOTATOC PET/CT detected additional hepatic and/or extrahepatic metastases in 22 of the 33 patients diagnosed with hepatic metastases on CT and/or MRI. Of the 15 patients evaluated for liver transplantation, we omitted 7 (46.6%) from further screening because of evidence of metastatic deposits not seen by conventional imaging. Overall, 68Ga-DOTATOC PET/CT altered our treatment decision based on CT and/or MRI alone, in 31 (59.6%) of the 52 patients.
CONCLUSIONS: In this study, 68Ga-DOTATOC PET/CT proved clearly superior to CT and/or MRI for detection and staging of NET. More important, 68Ga-DOTATOC PET/CT impacted our treatment decision in more than every second patient.
Authors:
Andrea Frilling; Georgios C Sotiropoulos; Arnold Radtke; Massimo Malago; Andreas Bockisch; Hilmar Kuehl; Jun Li; Christoph E Broelsch
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of surgery     Volume:  252     ISSN:  1528-1140     ISO Abbreviation:  Ann. Surg.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-01     Completed Date:  2010-12-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  850-6     Citation Subset:  AIM; IM    
Affiliation:
Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany. a.frilling@imperial.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Disease Progression
Female
Gallium Radioisotopes
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Staging
Neuroendocrine Tumors / pathology,  radiography*,  radionuclide imaging*
Octreotide / analogs & derivatives*,  diagnostic use
Positron-Emission Tomography / methods*
Radiopharmaceuticals / diagnostic use*
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*
Whole Body Imaging
Chemical
Reg. No./Substance:
0/(DOTA(0)-Phe(1)-Tyr(3))octreotide; 0/Gallium Radioisotopes; 0/Radiopharmaceuticals; 83150-76-9/Octreotide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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