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

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Abstract

Objective

To evaluate a simultaneous PET/MRI approach to imaging patients with neuroendocrine tumor using a combination of 68Ga-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 68Ga-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 68Ga-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.

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Acknowledgements

Grant support from Wylie J. Dodds Research Award, Society of Abdominal Radiology, GE Healthcare.

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Authors and Affiliations

  1. Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue – 0628, San Francisco, CA, 94143-0628, USA

    Thomas A. Hope, Miguel Hernandez Pampaloni, Henry VanBrocklin, James Slater, Salma Jivan, Carina Mari Aparici & Judy Yee

  2. Department of Radiology, San Francisco VA Medical Center, San Francisco, CA, USA

    Thomas A. Hope & Judy Yee

  3. Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, San Francisco, CA, USA

    Eric Nakakura

  4. Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Emily Bergsland

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  1. Thomas A. Hope
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  2. Miguel Hernandez Pampaloni
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  3. Eric Nakakura
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  4. Henry VanBrocklin
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  5. James Slater
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  6. Salma Jivan
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  7. Carina Mari Aparici
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  8. Judy Yee
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  9. Emily Bergsland
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Correspondence to Thomas A. Hope.

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Hope, T.A., Pampaloni, M.H., Nakakura, E. et al. Simultaneous 68Ga-DOTA-TOC PET/MRI with gadoxetate disodium in patients with neuroendocrine tumor. Abdom Imaging 40, 1432–1440 (2015). https://doi.org/10.1007/s00261-015-0409-9

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  • DOI: https://doi.org/10.1007/s00261-015-0409-9

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