Ga-68 DOTATATE PET/CT finds more NETs

Kathy Mahdoubi | | Health Imaging | Molecular Imaging

A comparison study of three different methods of neuroendocrine tumor (NET) detection that includes PET/CT, SPECT/CT and whole body MR imaging places PET/CT with gallium-68 (Ga-68) DOTATATE on a pedestal above the rest for its sensitivity in finding NETs, according to a study published Aug. 28 in the Journal of Nuclear Medicine.

Elba Cristina Sa de Camargo Etchebehere, PhD, from the division of nuclear medicine and PET/CT at Sirio Libanes Hospital in Sao Paulo, Brazil, and colleagues evaluated Tc-99m hydrazinonicotinamide (HYNIC)-octreotide somatostatin receptor scintigraphy (SSRS) SPECT/CT, Ga-68 DOTATATE PET/CT and whole-body diffusion-weighted MR imaging (WB DWI) to compare how each detected NETs.

For this prospective study, researchers imaged 19 consecutive patients using all three methods with no more than three-month intervals between imaging methods. Results of the study showed significant variability in NET scans of the pancreas, gastrointestinal tract and bone. Not only was Ga-68 DOTATATE PET/CT more sensitive for detecting NETs, but the technique resulted in the identification of two primary tumors that were not indicated by the other two methods. 

“Ga-68 DOTATATE PET/CT seems to be more sensitive for detection of NET lesions,” the authors concluded. “We propose a diagnostic algorithm that starts with staging of the patient with Ga-68 DOTATATE PET/CT.”

The comparison study found that Ga-68 DOTATATE PET/CT, SSRS SPECT/CT, and WB DWI had sensitivities of 0.96, 0.60 and 0.72, respectively; specificities of 0.97, 0.99 and 1.00. Positive predictive values were gauged at 0.94, 0.96 and 1.00, and negative predictive values at 0.98, 0.83 and 0.88. The three modes showed respective accuracy of 0.97, 0.86, and 0.91 for detecting NETs.

The researchers concluded that both Ga-68 DOTATATE PET/CT and WB DWI could be used to detect NETs. However, the reduced radiation of DWI may not be enough to warrant that route of imaging and it may not be accurate enough to use in therapy monitoring. They also concluded that SSRS SPECT/CT should only be used in the context of NET detectability when Ga-68 DOTATATE PET/CT is not available.


 

Kathy Mahdoubi

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