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Evaluation of 68Ga-DOTATOC PET/MRI for whole-body staging of neuroendocrine tumours in comparison with 68Ga-DOTATOC PET/CT

  • Oncology
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Abstract

Objectives

To compare the diagnostic performance of 68Ga-DOTATOC PET/MRI and 68Ga-DOTATOC PET/CT in the whole-body staging of patients with neuroendocrine tumours (NET).

Methods

Thirty patients with histopathologically confirmed NET underwent PET/CT and PET/MRI in a single-injection protocol. PET/CT and PET/MRI scans were prospectively evaluated with regard to lesion count, localization, nature (NET/non-NET), and conspicuity (four-point scale). Histopathology and follow-up imaging served as the reference standards. The proportions of NET and non-NET lesions rated correctly were compared using McNemar’s chi-squared test. The Wilcoxon test was used to assess differences in SUVmax and lesion conspicuity. The correlation between the SUVmax for the same lesions from each modality was analysed using Pearson’s correlation coefficient (r).

Results

According to the reference standard, there were 197 lesions (142 NET, 55 non-NET). Lesion-based analysis showed a higher proportion of correctly rated NET lesions on PET/MRI than on PET/CT (90.8% vs. 86.7%, p = 0.031), whereas on PET/CT there was a higher proportion of correctly rated non-NET lesions (94.5% vs. 83.6%, p = 0.031). SUVmax was strongly correlated (r = 0.86; p < 0.001) and did not differ significantly (p = 0.35) between the modalities. Overall conspicuity and NET lesion conspicuity were higher on PET/MRI (both p < 0.01).

Conclusions

Ga-DOTATOC PET/MRI yielded a higher proportion of correctly rated NET lesions and should be regarded as a valuable alternative to 68Ga-DOTATOC PET/CT in whole-body staging of NET patients.

Key Points

• 68 Ga-DOTATOC PET/MRI correctly identified more NET lesions than 68 Ga-DOTATOC PET/CT.

• 68 Ga-DOTATOC PET/MRI provides better NET lesion conspicuity than 68 Ga-DOTATOC PET/CT.

• SUVmax values from the two modalities are strongly correlated and do not differ significantly.

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References

  1. Klimstra DS, Beltran H, Lilenbaum R, Bergsland E (2015) The spectrum of neuroendocrine tumors: histologic classification, unique features and areas of overlap. Am Soc Clin Oncol Educ Book 92–103. doi:10.14694/EdBook_AM.2015.35.92

  2. Yao JC, Hassan M, Phan A et al (2008) One hundred years after "carcinoid": epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 26:3063–3072

    Article  PubMed  Google Scholar 

  3. Oberg K, Eriksson B (2005) Endocrine tumours of the pancreas. Best Pract Res Clin Gastroenterol 19:753–781

    Article  PubMed  Google Scholar 

  4. Skoura E, Michopoulou S, Mohmaduvesh M et al (2016) The impact of 68Ga-DOTATATE PET/CT imaging on management of patients with neuroendocrine tumours: experience from a national referral centre in the United Kingdom. J Nucl Med 57:34–40

    Article  CAS  PubMed  Google Scholar 

  5. Kulaksiz H, Eissele R, Rossler D et al (2002) Identification of somatostatin receptor subtypes 1, 2A, 3, and 5 in neuroendocrine tumours with subtype specific antibodies. Gut 50:52–60

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Kaemmerer D, Peter L, Lupp A et al (2011) Molecular imaging with 68Ga-SSTR PET/CT and correlation to immunohistochemistry of somatostatin receptors in neuroendocrine tumours. Eur J Nucl Med Mol Imaging 38:1659–1668

    Article  CAS  PubMed  Google Scholar 

  7. Krenning EP, Bakker WH, Breeman WA et al (1989) Localisation of endocrine-related tumours with radioiodinated analogue of somatostatin. Lancet 1:242–244

    Article  CAS  PubMed  Google Scholar 

  8. Hofman MS, Lau WF, Hicks RJ (2015) Somatostatin receptor imaging with 68Ga DOTATATE PET/CT: clinical utility, normal patterns, pearls, and pitfalls in interpretation. Radiographics 35:500–516

    Article  PubMed  Google Scholar 

  9. Treglia G, Castaldi P, Rindi G, Giordano A, Rufini V (2012) Diagnostic performance of gallium-68 somatostatin receptor PET and PET/CT in patients with thoracic and gastroenteropancreatic neuroendocrine tumours: a meta-analysis. Endocrine 42:80–87

    Article  CAS  PubMed  Google Scholar 

  10. Hope TA, Pampaloni MH, Nakakura E et al (2015) Simultaneous 68Ga-DOTA-TOC PET/MRI with gadoxetate disodium in patients with neuroendocrine tumor. Abdom Imaging 40:1432–1440

    Article  PubMed  Google Scholar 

  11. Beiderwellen KJ, Poeppel TD, Hartung-Knemeyer V et al (2013) Simultaneous 68Ga-DOTATOC PET/MRI in patients with gastroenteropancreatic neuroendocrine tumors: initial results. Investig Radiol 48:273–279

    Article  CAS  Google Scholar 

  12. Beiderwellen K, Grueneisen J, Ruhlmann V et al (2015) [(18)F]FDG PET/MRI vs. PET/CT for whole-body staging in patients with recurrent malignancies of the female pelvis: initial results. Eur J Nucl Med Mol Imaging 42:56–65

    Article  CAS  PubMed  Google Scholar 

  13. Grueneisen J, Schaarschmidt BM, Heubner M et al (2015) Implementation of FAST-PET/MRI for whole-body staging of female patients with recurrent pelvic malignancies: a comparison to PET/CT. Eur J Radiol 84:2097–2102

    Article  PubMed  Google Scholar 

  14. Geijer H, Breimer LH (2013) Somatostatin receptor PET/CT in neuroendocrine tumours: update on systematic review and meta-analysis. Eur J Nucl Med Mol Imaging 40:1770–1780

    Article  CAS  PubMed  Google Scholar 

  15. Spick C, Herrmann K, Czernin J (2016) 18F-FDG PET/CT and PET/MRI perform equally well in cancer: evidence from studies on more than 2,300 patients. J Nucl Med 57:420–430

    Article  PubMed  PubMed Central  Google Scholar 

  16. Schreiter NF, Nogami M, Steffen I et al (2012) Evaluation of the potential of PET-MRI fusion for detection of liver metastases in patients with neuroendocrine tumours. Eur Radiol 22:458–467

    Article  PubMed  Google Scholar 

  17. Beiderwellen K, Huebner M, Heusch P et al (2014) Whole-body [18F]FDG PET/MRI vs. PET/CT in the assessment of bone lesions in oncological patients: initial results. Eur Radiol 24:2023–2030

    Article  PubMed  Google Scholar 

  18. Schmidt GP, Schoenberg SO, Schmid R et al (2007) Screening for bone metastases: whole-body MRI using a 32-channel system versus dual-modality PET-CT. Eur Radiol 17:939–949

    Article  PubMed  Google Scholar 

  19. Sawicki LM, Grueneisen J, Buchbender C et al (2016) Comparative performance of 18F-FDG PET/MRI and 18F-FDG PET/CT regarding detection and characterization of pulmonary lesions in 121 oncologic patients. J Nucl Med 57:582–586

    Article  PubMed  Google Scholar 

  20. Rauscher I, Eiber M, Furst S et al (2014) PET/MR imaging in the detection and characterization of pulmonary lesions: technical and diagnostic evaluation in comparison to PET/CT. J Nucl Med 55:724–729

    Article  CAS  PubMed  Google Scholar 

  21. Schwenzer NF, Seith F, Gatidis S et al (2016) Diagnosing lung nodules on oncologic MR/PET imaging: comparison of fast T1-weighted sequences and influence of image acquisition in inspiration and expiration breath-hold. Korean J Radiol 17:684–694

    Article  PubMed  PubMed Central  Google Scholar 

  22. Durante C, Boukheris H, Dromain C et al (2009) Prognostic factors influencing survival from metastatic (stage IV) gastroenteropancreatic well-differentiated endocrine carcinoma. Endocr Relat Cancer 16:585–597

    Article  PubMed  Google Scholar 

  23. Riihimaki M, Hemminki A, Sundquist K, Sundquist J, Hemminki K (2016) The epidemiology of metastases in neuroendocrine tumors. Int J Cancer 139:2679–2686

    Article  PubMed  Google Scholar 

  24. Lombard-Bohas C, Mitry E, O'Toole D et al (2009) Thirteen-month registration of patients with gastroenteropancreatic endocrine tumours in France. Neuroendocrinology 89:217–222

    Article  CAS  PubMed  Google Scholar 

  25. Quick HH (2014) Integrated PET/MR. J Magn Reson Imaging 39:243–258

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany

    Lino M. Sawicki, Philipp Heusch & Gerald Antoch

  2. Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University Duisburg-Essen, 45122, Essen, Germany

    Cornelius Deuschl, Karsten Beiderwellen, Michael Forsting & Lale Umutlu

  3. Department of Nuclear Medicine, Medical Faculty, University Duisburg-Essen, 45122, Essen, Germany

    Lino M. Sawicki, Verena Ruhlmann, Thorsten D. Poeppel, Andreas Bockisch & Ken Herrmann

  4. Department of Endocrinology and Metabolism, Endocrine Tumour Center at WTZ and ENETS Center of Excellence, Medical Faculty, University Duisburg-Essen, D-45122, Essen, Germany

    Harald Lahner & Dagmar Führer

  5. Endocrine Tumour Center at WTZ and ENETS Center of Excellence, 45122, Essen, Germany

    Harald Lahner & Dagmar Führer

Authors
  1. Lino M. Sawicki
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  2. Cornelius Deuschl
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  12. Gerald Antoch
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Corresponding author

Correspondence to Lino M. Sawicki.

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Guarantor

The scientific guarantor of this publication is Ass. Prof. Dr. med. Lale Umutlu.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Funding

The authors state that this work did not receive any funding.

Statistics and biometry

One of the authors has significant statistical expertise.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was obtained from all patients in this study.

Study subject or cohort overlap

None of the study subjects or cohorts has been previously reported.

Methodology

• Prospective

• Diagnostic study

• Performed at one institution

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Sawicki, L.M., Deuschl, C., Beiderwellen, K. et al. Evaluation of 68Ga-DOTATOC PET/MRI for whole-body staging of neuroendocrine tumours in comparison with 68Ga-DOTATOC PET/CT. Eur Radiol 27, 4091–4099 (2017). https://doi.org/10.1007/s00330-017-4803-2

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  • DOI: https://doi.org/10.1007/s00330-017-4803-2

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