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The added value of 68Ga-DOTA-TATE-PET to contrast-enhanced CT for primary site detection in CUP of neuroendocrine origin

  • Nuclear Medicine
  • Published:
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Abstract

Objectives

To quantify the additional value of 68Ga-DOTA-TATE PET/CT in comparison with contrast-enhanced CT alone for primary tumour detection in neuroendocrine cancer of unknown primary (CUP-NET).

Methods

In total, 38 consecutive patients (27 men, 11 women; mean age 62 years) with histologically proven CUP-NET who underwent a contrast-enhanced 68Ga-DOTA-TATE PET/CT scan for primary tumour detection and staging between 2010 and 2014 were included in this IRB-approved retrospective study. Two blinded readers independently analysed the contrast-enhanced CT and 68Ga-DOTA-TATE PET datasets separately and noted from which modality they suspected a primary tumour. Consensus was reached if the results were divergent. Postoperative histopathology (24 patients) and follow-up 68Ga-DOTA-TATE PET/CT imaging (14 patients) served as the reference standards and statistical measures of diagnostic accuracy were calculated accordingly.

Results

The majority of confirmed primary tumours were located in the abdomen (ileum in 19 patients, pancreas in 12, lung in 2, small pelvis in 1). High interobserver agreement was noted regarding the suspected primary tumour site (Cohen’s k 0.90, p < 0.001). 68Ga-DOTA-TATE PET demonstrated a significantly higher sensitivity (94 % vs. 63 %, p = 0.005) and a significantly higher accuracy (87 % vs. 68 %, p = 0.003) than contrast-enhanced CT.

Conclusions

Ga-DOTA-TATE PET/CT compared with contrast-enhanced CT alone provides an improvement in sensitivity of 50 % and an improvement in accuracy of 30 % in primary tumour detection in CUP-NET.

Key Points

• 68Ga-DOTA-TATE PET augments the sensitivity of contrast-enhanced CT by 50 %

• 68Ga-DOTA-TATE PET augments the accuracy of contrast-enhanced CT by 30 %

• Somatostatin receptor-targeted hybrid imaging optimizes primary tumour detection in CUP-NET

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Acknowledgments

The scientific guarantor of this publication is PD Dr. med. Clemens C. Cyran. The authors of this manuscript declare relationships with the following companies:

Clemens C. Cyran: speaker’s bureau Siemens Healthcare, research grants Bayer HealthCare and Novartis.

Christine Spitzweg: honoraria for advisory board and lectures from Novartis, Pfizer and Ipsen.

Christoph Auernhammer: research grants and lecture honoraria from Novartis and Ipsen, advisory board honoraria from Novartis.

The authors state that this work has not received any funding. No complex statistical methods were necessary for this study. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Institut für Klinische Radiologie, Klinikum der Universität München, Marchioninistraße 15, 81377, München, Germany

    Philipp M. Kazmierczak

  2. Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, München, Germany

    Philipp M. Kazmierczak, Carsten Rist & Clemens C. Cyran

  3. Department of Nuclear Medicine, Ludwig-Maximilians-University Hospital Munich, München, Germany

    Axel Rominger & Vera Wenter

  4. Department of Internal Medicine II, Ludwig-Maximilians-University Hospital Munich, München, Germany

    Christine Spitzweg & Christoph Auernhammer

  5. Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Ludwig-Maximilians-University Hospital Munich, München, Germany

    Martin K. Angele

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  1. Philipp M. Kazmierczak
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Correspondence to Philipp M. Kazmierczak.

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Kazmierczak, P.M., Rominger, A., Wenter, V. et al. The added value of 68Ga-DOTA-TATE-PET to contrast-enhanced CT for primary site detection in CUP of neuroendocrine origin. Eur Radiol 27, 1676–1684 (2017). https://doi.org/10.1007/s00330-016-4475-3

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  • DOI: https://doi.org/10.1007/s00330-016-4475-3

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