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Role of 68Ga-DOTATATE PET/CT in patients with multiple endocrine neoplasia type 1 (MEN1)

  • Endocrine Methods and Techniques
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Abstract

Multiple endocrine neoplasia type 1 (MEN1) is a hereditary syndrome predisposing to many endocrine and neuroendocrine tumors (NET). Conventional imaging (CI) cannot provide satisfactory results for all the different types of MEN1-related tumors. Objective of this prospective observational study was to evaluate the role of 68Ga-DOTATATE PET/CT in MEN1 compared to CI. Diagnostic performance of 68Ga-DOTATATE PET/CT for the detection of NET was evaluated as well as the prognostic role of SUVmax. Eighteen patients with genetically confirmed MEN1 were evaluated by 68Ga-DOTATATE PET/CT, endoscopic ultrasounds, multidetector-row computed tomography, magnetic resonance imaging, and hormone/markers serum measurements. Four MEN1-related tumor sites (pancreas, pituitary, parathyroids, adrenals) were considered. Sensitivity and specificity of 68Ga-DOTATATE PET/CT for the detection of NET were calculated. There was 68Ga-DOTATATE PET/CT uptake in 11/11 patients with pancreatic lesions, in 9/12 with pituitary adenoma, in 5/15 with parathyroid enlargements, and in 5/7 with adrenal lesions. 68Ga-DOTATATE PET/CT showed sensitivity and specificity of 100 and 100 % in pancreas, 75 and 83 % in pituitary, 28 and 100 % in parathyroids, and 62.5 and 100 % in adrenals, respectively. Compared with CI, no significant difference in sensitivity for pancreas, pituitary, and adrenals was found, while CI had a better sensitivity for parathyroids (p = 0.002). On the ROC analysis, progression of pancreatic lesions was significantly associated to SUVmax <12.3 (p < 0.05). 68Ga-DOTATATE PET/CT is greatly helpful in the work-up of MEN1 providing a panoramic view of MEN1-related lesions. There is also a prognostic role of 68Ga-PET in patients with MEN1-pancreatic lesions.

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    Authors and Affiliations

    1. Division of Nuclear Medicine, Department of Diagnostic Imaging and Radiotherapy, Istituto Nazionale Tumori “Fondazione G.Pascale” - IRCCS Napoli, Naples, Italy

      Secondo Lastoria, Luigi Aloj, Corradina Caracò, Michela Aurilio, Laura D’Ambrosio & Francesca Di Gennaro

    2. Division of Endocrinology, Department of Clinical Medicine and Surgery, “Federico II” University of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy

      Francesca Marciello, Antongiulio Faggiano, Valeria Ramundo & Annamaria Colao

    3. Department of Biomorphological and Functional Sciences, “Federico II” University of Napoli, Naples, Italy

      Luigi Camera

    4. Gastrointestinal Unit, “Pellegrini Hospital”, Naples, Italy

      Leonardo De Luca

    5. Istitute of Biostructures and Bioimages (IBB), National Research Council, Naples, Italy

      Rosa Fonti

    6. Department of General and Specialistic Surgery, Second University of Napoli, Caserta, Italy

      Vincenzo Napolitano

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    1. Secondo Lastoria
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    2. Francesca Marciello
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    Correspondence to Secondo Lastoria or Francesca Marciello.

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    Secondo Lastoria and Francesca Marciello have equally contributed to the article.

    On the behalf of the Multidisciplinary Group for Neuroendocrine Tumors of Naples.

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    Lastoria, S., Marciello, F., Faggiano, A. et al. Role of 68Ga-DOTATATE PET/CT in patients with multiple endocrine neoplasia type 1 (MEN1). Endocrine 52, 488–494 (2016). https://doi.org/10.1007/s12020-015-0702-y

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    • DOI: https://doi.org/10.1007/s12020-015-0702-y

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