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Use of MRI and Ga-68 DOTATATE for the detection of neuroendocrine liver metastases

  • Hepatobiliary
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To compare detection rates of NET liver metastases of MRI and Ga-68-DOTATATE PET/CT to provide more clarity when selecting diagnostic imaging tests for NET staging.

Methods

In this IRB-approved single-institution retrospective study, all patients with pathology-proven NET who underwent Ga-68-DOTATATE and MRI scans within 8 weeks of each other (3/2017–2/2020) were reviewed. Number of metastases for each patient on diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE) MRI, and Ga-68 DOTATATE were recorded by two blinded radiologists, followed by consensus review with two separate blinded readers for MRI and nuclear medicine. Per-lesion and -modality scoring at each lesion location were then performed in consensus. Per-patient linear regression was performed comparing MRI and Ga-68 DOTATATE detection rates for each reader and in consensus, and per-lesion-matched pair difference means were used to compare detection frequency between modalities.

Results

32 patients (mean age 59 years, 59.4% male) and 90 liver metastases were analyzed. Intraclass coefficients (ICC) [95% CI] between the two readers were 0.97 [0.95, 0.99], 0.89 [0.82, 0.94], and 0.98 [0.97, 0.99] for Ga-68 DOTATATE, DWI, and DCE, respectively. Matched per-lesion mean differences were + 0.17 ± 0.07 (p = 0.01) and + 0.22 ± 0.06 (p =  < 0.001) for DWI versus Ga-68 DOTATATE and DCE vs Ga-68 DOTATATE, respectively, favoring MRI. Case-based linear regressions estimate that DWI and DCE detect 1.28 [1.07, 1.49] and 1.33 [1.12, 1.54] lesions, respectively, for each one detected on Ga-68 DOTATATE.

Conclusion

MRI detects more hepatic NET metastasis in comparison to Ga-68 DOTATATE. Liver MRI should be performed in concert with Ga-68 DOTATATE in NET staging.

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Data Availability

Raw data were generated at Beth Israel Deaconess Medical Center. Derived data supporting the findings of this study are available from the corresponding author L. L. T. on request.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Abdominal Imaging Division, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Maera Haider, Brian G. Jiang, Alexander Goehler & Leo L. Tsai

  2. Nuclear Medicine Division, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    John A. Parker

  3. Division of Hematology and Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Andrea J. Bullock

  4. Department of Diagnostic Radiology, Queen’s University Kingston Health Sciences Centre, Kingston, ON, Canada

    Maera Haider

Authors
  1. Maera Haider
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  2. Brian G. Jiang
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  4. Andrea J. Bullock
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  6. Leo L. Tsai
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Correspondence to Leo L. Tsai.

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Conflict of interest

Dr. Leo Tsai is a consultant for Agile Devices, a medical device company with no connection to this study. No other author disclosures are noted.

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Maera Haider and Brian G. Jiang are co-first authors.

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Haider, M., Jiang, B.G., Parker, J.A. et al. Use of MRI and Ga-68 DOTATATE for the detection of neuroendocrine liver metastases. Abdom Radiol 47, 586–595 (2022). https://doi.org/10.1007/s00261-021-03341-z

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  • DOI: https://doi.org/10.1007/s00261-021-03341-z

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