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68Ga-DOTATOC PET/CT in detecting neuroendocrine tumours responsible for initial or recurrent paraneoplastic Cushing’s syndrome

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Abstract

Purpose

Paraneoplastic Cushing’s syndrome (PCS) is frequently caused by neuroendocrine tumours (NETs). Approximately 20% of tumours are still occult years later. Gallium-68 somatostatin receptor-PET/CT is promising for the detection of the causal primary NET, but its role in case of recurrent PCS is rarely reported. We report our experience with DOTATOC PET/CT in localising the causal NET in cases of initial but also recurrent PCS, and its clinical impact.

Methods

A retrospective review of all DOTATOC PET/CTs performed in consecutive patients referred for PCS to our centre, between January 2011 and June 2017, was done. Nineteen patients underwent 26 PET/CTs, 13 for detection of a primary NET, seven for persistent or recurrent PCS after resection, and six for surveillance after resection of NETs previously detected on a DOTATOC PET/CT in our centre.

Results

Among the 13 PET/CTs performed to search for primary NET, five were positive: four carcinoid lung tumours were confirmed after resection and one lung focus was not confirmed since surgery would have carried a high risk. Clinical impact was 23% (3/13). Among the seven PET/CTs performed for persistent or recurrent PCS, six were true-positive, with confirmation of metastatic lymph nodes after resection. Clinical impact was 57% (4/7). All PET/CTs performed for surveillance were true-negative.

Conclusions

DOTATOC PET/CT seems to be a valuable tool for detection of the NET responsible for persistent or recurrent PCS after surgery. In this context, DOTATOC PET/CT was more effective than for the detection of the causal tumour in initial PCS.

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Acknowledgements

Dr Christina Balasa, hôpital Kremlin Bicêtre, Department of Radiology, 78 Rue du Général Leclerc, 94270 Le Kremlin-Bicêtre. Dr Camille Vatier, hôpital Saint-Antoine, Department of Endocrinology, 184 Rue du Faubourg Saint-Antoine, 75012 Paris. This work was performed in the Nuclear Medicine Department of Hôpital Tenon, Paris, France.

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Authors and Affiliations

  1. Nuclear Medicine, Hôpital Tenon APHP and Sorbonne University, Paris, France

    Ophélie Bélissant Benesty, Valérie Nataf, Jessica Ohnona, Laure Michaud, Jules Zhang-Yin, Jean-Noël Talbot & Françoise Montravers

  2. Endocrinology, Hôpital Cochin APHP and Paris Descartes University, Paris, France

    Jérôme Bertherat

  3. Endocrinology, Hôpital Bicêtre APHP and Université Paris Sud, Le Kremlin-Bicêtre, France

    Philippe Chanson

  4. Endocrinology, Centre Hospitalo-Universitaire de Caen and Université de Caen Normandie, Caen, France

    Yves Reznik

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  1. Ophélie Bélissant Benesty
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Correspondence to Ophélie Bélissant Benesty.

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All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Bélissant Benesty, O., Nataf, V., Ohnona, J. et al. 68Ga-DOTATOC PET/CT in detecting neuroendocrine tumours responsible for initial or recurrent paraneoplastic Cushing’s syndrome. Endocrine 67, 708–717 (2020). https://doi.org/10.1007/s12020-019-02098-2

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