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Parametric net influx rate imaging of 68Ga-DOTATATE in patients with neuroendocrine tumors: assessment of lesion detectability

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Abstract

Objectives

There has been developed a clinical dynamic total-body 68Ga-DOTATATE PET/CT imaging protocol that allows quantitative imaging of net influx rate (Ki). Using qualitative and quantitative analyses of clinical studies, this retrospective study aims to assess whether parametric Ki images improve lesion detectability.

Methods

Using a 194-cm axial field-of-view PET/CT scanner, 52 patients with neuroendocrine tumors underwent a 60-min dynamic total-body 68Ga-DOTATATE scan. Parametric Ki images and static standardized uptake value (SUV) images were generated. In addition to visual inspection of both sets of images, a quantitative analysis of 249 individual lesions was conducted using the target-to-background (TBR) metric.

Results

There were 52 patients who underwent dynamic total-body 68Ga-DOTATATE PET/CT scans. A total of 249 lesions were evaluated, of which 66 lesions were biopsy-proven and 183 lesions were unproven. Ki images produced two fewer false positives than the SUV images. Overall, our results from 66 proven NET lesions suggested similar sensitivity (98.5%) but improved accuracy (from 95.6 to 97.1%) and potentially enhanced specificity with Ki over SUV imaging. Besides, there was no difference in the number of pathological lesions identified visually in both images. However, Ki TBR was significantly higher than SUV TBR quantitatively (P < 0.001).

Conclusions

Patlak Ki imaging provides nuclear physicians with a PET image with higher tumor contrast which may enhance confidence in diagnosis with possibly reduced false positive results, albeit an equivalent detectability, compared to static SUV image.

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Data availability

Data are available based on the reasonable request to the corresponding author.

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Funding

This study was funded by the National Key Research and Development Program of China (Grant number: 2022YFC2406902 to H.S.), the Shanghai Municipal Key Clinical Specialty Project (Grant number: SHSLCZDZK03401 to H.S.), the Major Science and Technology Projects for Major New Drug Creation (Grant number: 2019ZX09302001 to H.S.), the Shanghai Science and Technology Committee Program (Grant number: 20DZ2201800 to H.S.), the Three-year Action Plan of Clinical Skills and Innovation of Shanghai Hospital Development Center (Grant number: SHDC2020CR3079B to H.S.), and the Next Generation Information Infrastructure Construction Project founded by Shanghai Municipal Commission of Economy and Informatization (Grant number: 201901014 to H.S.).

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Author notes

  1. Hongyan Yin and Guobing Liu contributed equally to this paper.

Authors and Affiliations

  1. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, People’s Republic of China

    Hongyan Yin, Guobing Liu, Wujian Mao, Jing Lv, Haojun Yu, Dengfeng Cheng, Liang Cai & Hongcheng Shi

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  1. Hongyan Yin
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Correspondence to Hongcheng Shi.

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Yin, H., Liu, G., Mao, W. et al. Parametric net influx rate imaging of 68Ga-DOTATATE in patients with neuroendocrine tumors: assessment of lesion detectability. Ann Nucl Med (2024). https://doi.org/10.1007/s12149-024-01922-8

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