68 Gallium-DOTATATE positron emission tomography-computed tomography (PET CT) changes management in a majority of patients with neuroendocrine tumors

Surgery. 2019 Jan;165(1):178-185. doi: 10.1016/j.surg.2018.03.030. Epub 2018 Nov 8.

Abstract

Background: 68Gallium-DOTATATE positron emission tomography-computed tomography (PET CT) has shown superior accuracy in detecting grade 1 and 2 neuroendocrine tumors over previous imaging modalities and was recently included in National Comprehensive Cancer Network guidelines. It remains unclear which patients benefit most from this imaging modality. We therefore reviewed our initial experience with 68Gallium-DOTATATE PET CT to evaluate its usefulness in diagnosing, staging, and surveilling neuroendocrine tumors.

Methods: Records of patients who underwent 68Gallium-DOTATATE PET CT from March to December 2017 were prospectively evaluated. The primary endpoint was whether 68Gallium-DOTATATE PET CT changes treatment in patients with neuroendocrine tumors. Descriptive statistics, Fisher exact tests, and nested logistic regressions were conducted.

Results: A total of 50 consecutive patients were included. Of these, 41 patients (82%) had a biopsy-proven neuroendocrine tumor at the time of imaging. The remaining 9 patients (18%) had symptoms or biochemistry suggestive of a neuroendocrine tumor with negative cross-sectional imaging. 68Gallium-DOTATATE PET CT changed management in 33 patients (66%). There were 24 patients with intermodality changes in management and 9 patients with intramodality changes in management. Patients with scans performed for staging had a higher likelihood of a change in management (P = .006).

Conclusion: Performing 68Gallium-DOTATATE PET CT should be considered for staging and surveillance of neuroendocrine tumors because it is frequently associated with changes in management.

MeSH terms

  • Clinical Decision-Making*
  • Digestive System Neoplasms / diagnostic imaging
  • Female
  • Gallium Radioisotopes*
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / diagnostic imaging*
  • Neuroendocrine Tumors / therapy*
  • Organometallic Compounds*
  • Positron Emission Tomography Computed Tomography*
  • Prospective Studies
  • Thymus Neoplasms / diagnostic imaging

Substances

  • Gallium Radioisotopes
  • Organometallic Compounds
  • gallium Ga 68 dotatate