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Endocrine

, Volume 42, Issue 1, pp 80–87 | Cite as

Diagnostic performance of Gallium-68 somatostatin receptor PET and PET/CT in patients with thoracic and gastroenteropancreatic neuroendocrine tumours: a meta-analysis

  • Giorgio Treglia
  • Paola Castaldi
  • Guido Rindi
  • Alessandro Giordano
  • Vittoria Rufini
Meta-Analysis

Abstract

Gallium-68 somatostatin receptor (SMSR) positron emission tomography (PET) and positron emission tomography/computed tomography (PET/CT) are valuable diagnostic tools for patients with neuroendocrine tumours (NETs). To date, a meta-analysis about the diagnostic accuracy of these imaging methods is lacking. Aim of our study is to meta-analyse published data about the diagnostic performance of SMSR PET or PET/CT in patients with thoracic and/or gastroenteropancreatic (GEP) NETs. A comprehensive computer literature search of studies published in PubMed/MEDLINE, Scopus and Embase databases through October 2011 and regarding SMSR PET or PET/CT in patients with NETs was carried out. Only studies in which SMSR PET or PET/CT were performed in patients with thoracic and/or GEP NETs were selected (medullary thyroid tumours and neural crest derived tumours were excluded from the analysis). Pooled sensitivity, pooled specificity and area under the ROC curve were calculated to measure the diagnostic accuracy of SMSR PET and PET/CT in NETs. Results: Sixteen studies comprising 567 patients were included in this meta-analysis. The pooled sensitivity and specificity of SMSR PET or PET/CT in detecting NETs were 93% (95% confidence interval [95% CI]: 91–95%) and 91% (95% CI: 82–97%), respectively, on a per patient-based analysis. The area under the ROC curve was 0.96. In patients with suspicious thoracic and/or GEP NETs, SMSR PET and PET/CT demonstrated high sensitivity and specificity. These accurate techniques should be considered as first-line diagnostic imaging methods in patients with suspicious thoracic and/or GEP NETs.

Keywords

PET PET/CT Somatostatin analogues Neuroendocrine tumours Gallium-68 

Notes

Acknowledgment

Authors are grateful to Ms. Barbara Muoio for her technical support in bibliographic research.

References

  1. 1.
    A. Faggiano, P. Ferolla, F. Grimaldi, D. Campana, M. Manzoni, M.V. Davì, A. Bianchi, R. Valcavi, E. Papini, D. Giuffrida, D. Ferone, G. Fanciulli, G. Arnaldi, G.M. Franchi, G. Francia, G. Fasola, L. Crino, A. Pontecorvi, P. Tomassetti, A. Colao, Natural history of gastro-entero-pancreatic and thoracic neuroendocrine tumors. Data from a large prospective and retrospective Italian Epidemiological study: the net management study. J. Endocrinol. Invest. (2011). doi: 10.3275/8102
  2. 2.
    G. Rindi, B. Wiedenmann, Neuroendocrine neoplasms of the gut and pancreas: new insights. Nat. Rev. Endocrinol. 8, 54–64 (2011)PubMedCrossRefGoogle Scholar
  3. 3.
    V. Ambrosini, M. Fani, S. Fanti, F. Forrer, H.R. Maecke, Radiopeptide imaging and therapy in Europe. J. Nucl. Med. 52(Suppl 2), 42S–55S (2011)PubMedCrossRefGoogle Scholar
  4. 4.
    M.M. Graham, Y. Menda, Radiopeptide imaging and therapy in the United States. J. Nucl. Med. 52(Suppl 2), 56S–63S (2011)PubMedCrossRefGoogle Scholar
  5. 5.
    V. Rufini, M.L. Calcagni, R.P. Baum, Imaging of neuroendocrine tumors. Semin. Nucl. Med. 36, 228–247 (2006)PubMedCrossRefGoogle Scholar
  6. 6.
    D.J. Kwekkeboom, E.P. Krenning, K. Scheidhauer, V. Lewington, R. Lebtahi, A. Grossman, P. Vitek, A. Sundin, Mallorca consensus conference participants; European Neuroendocrine Tumor Society. ENETS consensus guidelines for the standards of care in neuroendocrine tumors: somatostatin receptor imaging with (111)In-pentetreotide. Neuroendocrinology 90, 184–189 (2009)PubMedCrossRefGoogle Scholar
  7. 7.
    A.I. Vinik, E.A. Woltering, R.R. Warner, M. Caplin, T.M. O’Dorisio, G.A. Wiseman, D. Coppola, North American Neuroendocrine Tumor Society (NANETS). NANETS consensus guidelines for the diagnosis of neuroendocrine tumor. Pancreas 39, 713–734 (2010)PubMedCrossRefGoogle Scholar
  8. 8.
    N.F. Schreiter, W. Brenner, M. Nogami, R. Buchert, A. Huppertz, U.F. Pape, V. Prasad, B. Hamm, M.H. Maurer, Cost comparison of (111)In-DTPA-octreotide scintigraphy and (68)Ga-DOTATOC PET/CT for staging enteropancreatic neuroendocrine tumours. Eur. J. Nucl. Med. Mol. Imaging 39, 72–82 (2012)PubMedCrossRefGoogle Scholar
  9. 9.
    J. Zamora, V. Abraira, A. Muriel, K. Khan, A. Coomarasamy, Meta-DiSc: a software for meta-analysis of test accuracy data. BMC Med. Res. Methodol. 6, 31 (2006)PubMedCrossRefGoogle Scholar
  10. 10.
    M. Hofmann, H. Maecke, R. Börner, E. Weckesser, P. Schöffski, L. Oei, J. Schumacher, M. Henze, A. Heppeler, J. Meyer, H. Knapp, Biokinetics and imaging with the somatostatin receptor PET radioligand (68)Ga-DOTATOC: preliminary data. Eur. J. Nucl. Med. 28, 1751–1757 (2001)PubMedCrossRefGoogle Scholar
  11. 11.
    S. Koukouraki, L.G. Strauss, V. Georgoulias, J. Schuhmacher, U. Haberkorn, N. Karkavitsas, A. Dimitrakopoulou-Strauss, Evaluation of the pharmacokinetics of 68Ga-DOTATOC in patients with metastatic neuroendocrine tumours scheduled for 90Y-DOTATOC therapy. Eur. J. Nucl. Med. Mol. Imaging 33, 460–466 (2006)PubMedCrossRefGoogle Scholar
  12. 12.
    M. Gabriel, C. Decristoforo, D. Kendler, G. Dobrozemsky, D. Heute, C. Uprimny, P. Kovacs, E. Von Guggenberg, R. Bale, I.J. Virgolini, 68Ga-DOTA-Tyr3-octreotide PET in neuroendocrine tumors: comparison with somatostatin receptor scintigraphy and CT. J. Nucl. Med. 48, 508–518 (2007)PubMedCrossRefGoogle Scholar
  13. 13.
    I. Buchmann, M. Henze, S. Engelbrecht, M. Eisenhut, A. Runz, M. Schäfer, T. Schilling, S. Haufe, T. Herrmann, U. Haberkorn, Comparison of 68Ga-DOTATOC PET and 111In-DTPAOC (Octreoscan) SPECT in patients with neuroendocrine tumours. Eur. J. Nucl. Med. Mol. Imaging 34, 1617–1626 (2007)PubMedCrossRefGoogle Scholar
  14. 14.
    I. Kayani, J.B. Bomanji, A. Groves, G. Conway, S. Gacinovic, T. Win, J. Dickson, M. Caplin, P.J. Ell, Functional imaging of neuroendocrine tumors with combined PET/CT using 68Ga-DOTATATE (DOTA-DPhe1, Tyr3-octreotate) and 18F-FDG. Cancer 112, 2447–2455 (2008)PubMedCrossRefGoogle Scholar
  15. 15.
    V. Ambrosini, P. Tomassetti, P. Castellucci, D. Campana, G. Montini, D. Rubello, C. Nanni, A. Rizzello, R. Franchi, S. Fanti, Comparison between 68Ga-DOTA-NOC and 18F-DOPA PET for the detection of gastro-entero-pancreatic and lung neuro-endocrine tumours. Eur. J. Nucl. Med. Mol. Imaging 35, 1431–1438 (2008)PubMedCrossRefGoogle Scholar
  16. 16.
    V. Ambrosini, P. Castellucci, D. Rubello, C. Nanni, A. Musto, V. Allegri, G.C. Montini, S. Mattioli, G. Grassetto, A. Al-Nahhas, R. Franchi, S. Fanti, 68Ga-DOTA-NOC: a new PET tracer for evaluating patients with bronchial carcinoid. Nucl. Med. Commun. 30, 281–286 (2009)PubMedCrossRefGoogle Scholar
  17. 17.
    I. Kayani, B.G. Conry, A.M. Groves, T. Win, J. Dickson, M. Caplin, J.B. Bomanji, A comparison of 68Ga-DOTATATE and 18F-FDG PET/CT in pulmonary neuroendocrine tumors. J. Nucl. Med. 50, 1927–1932 (2009)PubMedCrossRefGoogle Scholar
  18. 18.
    A. Haug, C.J. Auernhammer, B. Wängler, R. Tiling, G. Schmidt, B. Göke, P. Bartenstein, G. Pöpperl, Intraindividual comparison of 68Ga-DOTA-TATE and 18F-DOPA PET in patients with well-differentiated metastatic neuroendocrine tumours. Eur. J. Nucl. Med. Mol. Imaging 36, 765–770 (2009)PubMedCrossRefGoogle Scholar
  19. 19.
    A. Frilling, G.C. Sotiropoulos, A. Radtke, M. Malago, A. Bockisch, H. Kuehl, J. Li, C.E. Broelsch, The impact of 68Ga-DOTATOC positron emission tomography/computed tomography on the multimodal management of patients with neuroendocrine tumors. Ann. Surg. 252, 850–856 (2010)PubMedCrossRefGoogle Scholar
  20. 20.
    T. Jindal, A. Kumar, B. Venkitaraman, R. Dutta, R. Kumar, Role of (68)Ga-DOTATOC PET/CT in the evaluation of primary pulmonary carcinoids. Korean J. Intern. Med. 25, 386–391 (2010)PubMedCrossRefGoogle Scholar
  21. 21.
    Y. Krausz, N. Freedman, R. Rubinstein, E. Lavie, M. Orevi, S. Tshori, A. Salmon, B. Glaser, R. Chisin, E. Mishani, D. Gross J, 68Ga-DOTA-NOC PET/CT imaging of neuroendocrine tumors: comparison with ¹¹¹In-DTPA-octreotide (OctreoScan®). Mol. Imaging Biol. 13, 583–593 (2011)PubMedCrossRefGoogle Scholar
  22. 22.
    R. Srirajaskanthan, I. Kayani, A.M. Quigley, J. Soh, M.E. Caplin, J. Bomanji, The role of 68Ga-DOTATATE PET in patients with neuroendocrine tumors and negative or equivocal findings on 111In-DTPA-octreotide scintigraphy. J. Nucl. Med. 51, 875–882 (2010)PubMedCrossRefGoogle Scholar
  23. 23.
    A. Versari, L. Camellini, G. Carlinfante, A. Frasoldati, F. Nicoli, E. Grassi, C. Gallo, F.P. Giunta, A. Fraternali, D. Salvo, M. Asti, F. Azzolini, V. Iori, R. Sassatelli, Ga-68 DOTATOC PET, endoscopic ultrasonography, and multidetector CT in the diagnosis of duodenopancreatic neuroendocrine tumors: a single-centre retrospective study. Clin. Nucl. Med. 35, 321–328 (2010)PubMedCrossRefGoogle Scholar
  24. 24.
    J. Ruf, J. Schiefer, C. Furth, O. Kosiek, S. Kropf, F. Heuck, T. Denecke, M. Pavel, A. Pascher, B. Wiedenmann, H. Amthauer, 68Ga-DOTATOC PET/CT of neuroendocrine tumors: spotlight on the CT phases of a triple-phase protocol. J. Nucl. Med. 52, 697–704 (2011)PubMedCrossRefGoogle Scholar
  25. 25.
    N. Naswa, P. Sharma, A. Kumar, A.H. Nazar, R. Kumar, S. Chumber, C. Bal, Gallium-68-DOTA-NOC PET/CT of patients with gastroenteropancreatic neuroendocrine tumors: a prospective single-center study. AJR Am. J. Roentgenol. 197, 1221–1228 (2011)PubMedCrossRefGoogle Scholar
  26. 26.
    K.I. Alexandraki, G. Kaltsas, Gastroenteropancreatic neuroendocrine tumors: new insights in the diagnosis and therapy. Endocrine 41, 40–52 (2012)PubMedCrossRefGoogle Scholar
  27. 27.
    K.L. Yim, Role of biological targeted therapies in gastroenteropancreatic neuroendocrine tumours. Endocrine 40, 181–186 (2011)PubMedCrossRefGoogle Scholar
  28. 28.
    H. Xu, M. Zhang, G. Zhai, M. Zhang, G. Ning, B. Li, The role of integrated (18)F-FDG PET/CT in identification of ectopic ACTH secretion tumors. Endocrine 36, 385–391 (2009)PubMedCrossRefGoogle Scholar
  29. 29.
    T.D. Poeppel, I. Binse, S. Petersenn, H. Lahner, M. Schott, G. Antoch, W. Brandau, A. Bockisch, C. Boy, 68Ga-DOTATOC versus 68Ga-DOTATATE PET/CT in functional imaging of neuroendocrine tumors. J. Nucl. Med. 52, 1864–1870 (2011)PubMedCrossRefGoogle Scholar
  30. 30.
    D. Wild, B.J. Bomanji, J.C. Reubi, H.R. Maecke, M.E. Caplin, P.J. Ell, Comparison of 68Ga-DOTA-NOC and 68Ga-DOTA-TATE PET/CT in the detection of GEP NETs. Eur. J. Nucl. Med. Mol. Imaging 36(Suppl 2), S201 (2009)Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Giorgio Treglia
    • 1
  • Paola Castaldi
    • 1
  • Guido Rindi
    • 2
  • Alessandro Giordano
    • 1
  • Vittoria Rufini
    • 1
  1. 1.Institute of Nuclear MedicineCatholic University of the Sacred HeartRomeItaly
  2. 2.Institute of PathologyCatholic University of the Sacred HeartRomeItaly

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