Simultaneous (68)Ga-DOTA-TOC PET/MRI with gadoxetate disodium in patients with neuroendocrine tumor

Abdom Imaging. 2015 Aug;40(6):1432-40. doi: 10.1007/s00261-015-0409-9.

Abstract

Objective: To evaluate a simultaneous PET/MRI approach to imaging patients with neuroendocrine tumor using a combination of (68)Ga-DOTA-TOC as a PET contrast agent and gadoxetate disodium as a hepatobiliary MRI contrast agent.

Materials and methods: Ten patients with neuroendocrine tumor with known or suspected hepatic disease were imaged using a (68)Ga-DOTA-TOC PET/CT immediately followed by a 3.0T time-of-flight PET/MRI, using a combined whole body and liver specific imaging. The presence of lesions and DOTA-TOC avidity were assessed on CT, PET from PET/CT, diffusion weighted imaging, hepatobiliary phase imaging (HBP), and PET from PET/MRI. Maximum standardized uptake values (SUVmax) in hepatic lesions and nodal metastases were compared between PET/CT and PET/MRI, as were detection rates using each imaging approach.

Results: A total of 101 hepatic lesions were identified, 47 of which were DOTA-TOC avid and able to be individually measured on both PET/CT and PET/MRI. HBP imaging had a higher sensitivity for detection of hepatic lesions compared to CT or PET (99% vs. 46% and 64%, respectively; p values <0.001). There was a strong correlation between SUVmax of liver lesions obtained with PET/CT compared to PET/MR imaging (Pearson's correlation = 0.91). For nodal disease, CT had a higher sensitivity compared to whole body MRI (p = 0.015), although PET acquired from PET/MRI detected slightly more lesions compared to PET from PET/CT.

Conclusions: A simultaneous PET/MRI using both (68)Ga-DOTA-TOC and gadoxetate disodium was successful in whole body staging of patients with neuroendocrine tumor. HBP imaging had an increased detection rate for hepatic metastases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Gadolinium DTPA*
  • Gallium Radioisotopes
  • Humans
  • Image Enhancement
  • Liver / diagnostic imaging
  • Liver / pathology
  • Liver Neoplasms / diagnosis*
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Neuroendocrine Tumors / diagnosis*
  • Octreotide / analogs & derivatives*
  • Organometallic Compounds*
  • Positron-Emission Tomography*
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Whole Body Imaging

Substances

  • Contrast Media
  • Ga(III)-DOTATOC
  • Gallium Radioisotopes
  • Organometallic Compounds
  • Radiopharmaceuticals
  • gadolinium ethoxybenzyl DTPA
  • Gadolinium DTPA
  • Octreotide