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Comparison of [18F]-OC PET/CT and contrast-enhanced CT/MRI in the detection and evaluation of neuroendocrine neoplasms

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

An Editorial to this article was published on 24 May 2023

Abstract

Objectives

Gallium-68 (68Ga)–labeled somatostatin analog (SSA) PET imaging has been widely used in clinical practice of neuroendocrine neoplasms (NENs). Compared with 68Ga, 18F has a great practical and economic advantage. Although a few studies have shown the characteristics of [18F] AlF-NOTA-octreotide ([18F]-OC) in healthy volunteers and small NEN patient groups, its clinical value needs further investigation. Herein, this retrospective study aimed to evaluate the diagnostic accuracy of [18F]-OC PET/CT in detecting NENs, as well as to compare it with contrast-enhanced CT/MRI.

Methods

We retrospectively reviewed the data of 93 patients who had undergone [18F]-OC PET/CT and CT or MRI scans. Of these patients, there were 45 patients with suspected NENs for diagnostic evaluation, and 48 patients with pathologically confirmed NENs for detecting metastasis or recurrence. [18F]-OC PET/CT images were evaluated visually and semi-quantitatively by measuring maximum standardized uptake value of tumor (SUVmax), tumor-to-background SUVmax ratio (TBR), and SUVmax of hypophysis (SUVhypophysis). A total of 276 suspected NEN lesions were found in these 93 patients. The results of histopathology or radiographic follow-up served as the reference standard for the final diagnosis.

Results

Forty-five patients with suspected NENs were confirmed by histopathological examination via resection or biopsy. [18F]-OC PET/CT showed high radiotracer uptake in the lesions of G1-G3 NENs. [18F]-OC PET/CT showed superior performance with 96.3% of sensitivity, 77.8% of specificity, and 88.9% of accuracy in diagnosing NENs compared to CT/MRI. When cutoffs of SUVmax, TBR, and SUVhypophysis were 8.3, 3.1, and 15.4, [18F]-OC PET/CT had the best equilibrium between sensitivity and specificity for differentiating NEN from non-NEN lesions. For a total of 276 suspected NEN lesions, the sensitivity, specificity, and accuracy of [18F]-OC PET/CT for diagnosis of NENs were 90.5%, 82.1%, and 88.8%, respectively, and were higher than those of CT and MRI. G1 and G2 NENs had higher TBR and lower CT enhancement intensity than G3. The SUVmax and TBR had a positive correlation with CT enhancement intensity in G2 rather than in G1 or G3.

Conclusions

[18F]-OC PET/CT is a promising imaging modality for initial diagnosis and detecting metastasis or postoperative recurrence in NENs.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We gratefully acknowledge our colleagues for their comments on this study.

Funding

This work was supported by grants from the National Natural Science Foundation of China (NSFC) (82071965) and Huadong Medicine Joint Funds of the Zhejiang Provincial Natural Science Foundation of China (LHDMZ22H300010).

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Authors and Affiliations

  1. Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, People’s Republic of China

    Donghe Chen, Shuye Yang, Tiancheng Li, Yinuo Liu, Xin Zhao, Tingting Zhang, Mimi Xu, Huatao Wang, Kui Zhao & Xinhui Su

  2. Pharmacy Intravenous Admixture Services (PIVAS), The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China

    Jingjing Chen

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  1. Donghe Chen
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Contributions

DC and XS: study conception and design; drafting of manuscript; critical revision; review, analysis, and interpretation of scientific literature; YC: conducted management of the specimen samples of the patient; drafting of manuscript; KZ, TL, KL, ZW, SY, and GW: drafting of manuscript; review, analysis and interpretation of scientific literature. All authors have contributed to the manuscript and approved its final version.

Corresponding authors

Correspondence to Kui Zhao or Xinhui Su.

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The study was approved by the Ethics Committee of The first Affiliated Hospital, College of Medicine, Zhejiang University.

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The authors declare no competing interests.

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Chen, D., Yang, S., Chen, J. et al. Comparison of [18F]-OC PET/CT and contrast-enhanced CT/MRI in the detection and evaluation of neuroendocrine neoplasms. Eur J Nucl Med Mol Imaging 50, 2420–2431 (2023). https://doi.org/10.1007/s00259-023-06200-9

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  • DOI: https://doi.org/10.1007/s00259-023-06200-9

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