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van Vliembergen ENM, Pieterman CRC, van de Ven AC, Braat AJAT, Valk GD, de Laat JM. The natural course of cystic pancreatic neuroendocrine tumours in MEN1. ENDOCRINE ONCOLOGY (BRISTOL, ENGLAND) 2025; 5:e240050. [PMID: 39949334 PMCID: PMC11825168 DOI: 10.1530/eo-24-0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 12/19/2024] [Accepted: 01/22/2025] [Indexed: 02/16/2025]
Abstract
Pancreatic neuroendocrine tumours (PanNETs) significantly impact life expectancy in multiple endocrine neoplasia type 1 (MEN1). Both solid and cystic pancreatic lesions are observed in MEN1, yet limited research has been focused on cystic lesions in MEN1. While solid PanNETs are generally considered to have an indolent course, the natural course of cystic lesions remains unclear. This study aims to provide more insights into the natural course of cystic PanNETs in MEN1. Patients with MEN1 and radiologically suspected PanNETs, treated at UMC Utrecht and Radboudumc between 2010 and 2023, were included. In the first part, we examined the characteristics of patients with tumours visible on imaging scans. In the second part, we investigated outcomes of pathological examinations, following resection of these lesions. A total of 136 patients were included, comprising 60 men and 76 women. The median follow-up was 5.1 years. [68Ga]Ga-DOTATOC PET/CT scans showed that both cystic and solid lesions demonstrated [68Ga]Ga-DOTATOC PET/CT uptake. The median growth of cystic and solid PanNETs was similar. Pathological examination of 38 resected tumours confirmed that cystic lesions identified on imaging were indeed PanNETs. Cystic lesions had a median diameter of 26 mm at the time of resection, compared to 18 mm for solid lesions, with comparable Ki-67 indices and mitotic counts. We conclude that cystic and solid PanNETs in MEN1 patients appear to be morphological variations of the same entity, suggesting that similar management approaches should be considered.
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Affiliation(s)
- Eline N M van Vliembergen
- Department of Endocrine Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Endocrinology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carolina R C Pieterman
- Department of Endocrine Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Arthur J A T Braat
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Gerlof D Valk
- Department of Endocrine Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Joanne M de Laat
- Department of Endocrine Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Endocrinology, Radboud University Medical Centre, Nijmegen, The Netherlands
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2
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Hope TA, Allen-Auerbach M, Bodei L, Calais J, Dahlbom M, Dunnwald LK, Graham MM, Jacene HA, Heath CL, Mittra ES, Wright CL, Fendler WP, Herrmann K, Taïeb D, Kjaer A. SNMMI Procedure Standard/EANM Practice Guideline for SSTR PET: Imaging Neuroendocrine Tumors. J Nucl Med 2023; 64:204-210. [PMID: 36725249 DOI: 10.2967/jnumed.122.264860] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 08/30/2022] [Indexed: 02/03/2023] Open
Affiliation(s)
- Thomas A Hope
- Department of Radiology, San Francisco VA Medical Center, San Francisco, California; .,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Martin Allen-Auerbach
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, California
| | - Lisa Bodei
- Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, Weill Medical College of Cornell University, New York, New York
| | - Jeremie Calais
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, California
| | - Magnus Dahlbom
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, California
| | - Lisa K Dunnwald
- Department of Radiology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Michael M Graham
- Department of Radiology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Heather A Jacene
- Department of Imaging, Dana-Farber Cancer Institute, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Courtney Lawhn Heath
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Erik S Mittra
- Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Oregon
| | - Chadwick L Wright
- Wright Center of Innovation and Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Wolfgang P Fendler
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - David Taïeb
- Department of Nuclear Medicine, La Timone University Hospital, CERIMED, Aix-Marseille University, Marseille, France; and
| | - Andreas Kjaer
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
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3
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Gallicchio R, Giordano A, Milella M, Storto R, Pellegrino T, Nardelli A, Nappi A, Tarricone L, Storto G. Ga-68-Edotreotide Positron Emission Tomography/Computed Tomography Somatostatin Receptors Tumor Volume Predicts Outcome in Patients With Primary Gastroenteropancreatic Neuroendocrine Tumors. Cancer Control 2023; 30:10732748231152328. [PMID: 36714951 PMCID: PMC9940184 DOI: 10.1177/10732748231152328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND We retrospectively aimed to assess the prognostic significance of somatostatin receptor (SSTR) standardized uptake value (SUVmaxsstr), SSTR representative tumor volume (RTVsstr) and total lesion SSTR expression (TLsstr) obtained by [68Ga]Ga-edotreotide PET/CT ([68Ga]Ga-SSTR PET/CT) in patients with primary gastroenteropancreatic neuroendocrine tumors (GEP-NET) before surgery. MATERIAL AND METHODS We analyzed patients who underwent [68Ga]Ga-SSTR PET/CT 3-6 weeks before surgery from February 2020 to April 2022. The mean SUVmaxsstr value, the RTVsstr (cm3; 42% threshold) and the TLsstr (g) were registered. Thereafter the patients were followed up 10.3 months (range 3-27). The PET/CT results were compared to the event free survival (EFS). RESULTS Forty-two patients (61 ± 13 years) have been enrolled. At multivariate analysis only RTVsstr values were predictive. The Kaplan-Meier survival analysis for RTVsstr showed a significant better EFS in patients presenting lower values as compared to those having greater (P = .003, log-rank test). SUVmaxsstr was not suitable for predicting EFS, TLsstr mildly. CONCLUSION RTVsstr represents a valuable volumetric parameter able to predict the outcome in GEP-NET patients who underwent surgery. The magnitude of the SSTR representative tumor burden holds a predominant value for determining the response to therapy in GEP-NET patients before surgery, rather than the maximal SSTR representation at single voxel.
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Affiliation(s)
- Rosj Gallicchio
- Nuclear Medicine, Referral Cancer Center of Basilicata, IRCCS CROB, Rionero in Vulture, Italy
| | - Alessia Giordano
- Nuclear Medicine, Referral Cancer Center of Basilicata, IRCCS CROB, Rionero in Vulture, Italy
| | - Mariarita Milella
- Nuclear Medicine, Referral Cancer Center of Basilicata, IRCCS CROB, Rionero in Vulture, Italy
| | - Rebecca Storto
- Nuclear Medicine, Referral Cancer Center of Basilicata, IRCCS CROB, Rionero in Vulture, Italy
| | - Teresa Pellegrino
- Nuclear Medicine, Referral Cancer Center of Basilicata, IRCCS CROB, Rionero in Vulture, Italy
| | - Anna Nardelli
- Nuclear Medicine, Referral Cancer Center of Basilicata, IRCCS CROB, Rionero in Vulture, Italy
| | - Antonio Nappi
- Nuclear Medicine, Referral Cancer Center of Basilicata, IRCCS CROB, Rionero in Vulture, Italy
| | - Luigia Tarricone
- Nuclear Medicine, Referral Cancer Center of Basilicata, IRCCS CROB, Rionero in Vulture, Italy
| | - Giovanni Storto
- Nuclear Medicine, Referral Cancer Center of Basilicata, IRCCS CROB, Rionero in Vulture, Italy,Giovanni Storto, Referral Cancer Center of Basilicata, IRCCS CROB, Via P. Pio 1, Rionero in Vulture 85028, Italy.
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4
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Bentestuen M, Gossili F, Almasi CE, Zacho HD. Prevalence and significance of incidental findings on 68 Ga-DOTA-conjugated somatostatin receptor-targeting peptide PET/CT: a systematic review of the literature. Cancer Imaging 2022; 22:44. [PMID: 36057635 PMCID: PMC9441055 DOI: 10.1186/s40644-022-00484-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
Aim We aimed to evaluate the prevalence of incidental 68 Ga-DOTA-conjugated somatostatin receptor-targeting peptide PET/CT (SSTR PET/CT) findings, their clinical significance in the need for follow-up, and their risk of malignancy. Materials and methods Studies reporting incidental SSTR PET/CT findings were systematically searched in PubMed, Cochrane, Embase and Web of Science literature published prior to 1st of May 2020. Studies were filtered by two independent readers for eligibility based on title and abstract, and subsequently on full text. The main exclusion criteria were: 1) pathological findings that matched scan indication, 2) known organ specific disease and/or incidental findings confirmed on other scan modality prior to SSTR PET/CT, 3) lack of diagnosis and/or follow up, and 4) results published in proceedings or conference abstracts. Results Twenty-one studies, comprising a total of 2906 subjects, were eligible for the analysis. Studies included were retrospective cohort studies on incidental SSTR PET/CT findings in a specific organ (n = 2888, 7/21) or case reports (n = 18, 14/21). A total of 133 subjects had incidental SSTR PET/CT findings. Incidental findings were predominantly seen in the thyroid gland (n = 65), spine (n = 30), brain (n = 26) and breast (n = 6). Seventeen of 133 (13%) incidental findings were malignant on final diagnosis. Incidental breast findings were associated with the highest risk of malignancy (67%). In the thyroid, incidental SSTR uptake was caused by malignancy in 8%, all presenting as focal uptake. The lowest risk was seen in the spine with a malignancy rate of 3% in patients with incidental SSTR uptake and benign cases were interpreted as vertebral hemangiomas on CT. Incidental SSTR PET/CT findings in other locations were of malignant etiology in two out of six cases (33%) and should be evaluated individually. Conclusion The most incidental SSTR PET/CT findings were found in the thyroid gland, spine, and brain. The risk of malignancy was greatest in incidental SSTR PET/CT findings in the breast, cranially, and thyroid gland. The results of the present study can prove useful in the interpretation of atypical findings on SSTR PET/CT and in the counseling of clinicians. Supplementary Information The online version contains supplementary material available at 10.1186/s40644-022-00484-0.
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Affiliation(s)
- Morten Bentestuen
- Department of Nuclear Medicine and Clinical Cancer Research Center, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.
| | - Farid Gossili
- Department of Nuclear Medicine and Clinical Cancer Research Center, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark
| | - Charlotte Elberling Almasi
- Department of Nuclear Medicine and Clinical Cancer Research Center, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark
| | - Helle Damgaard Zacho
- Department of Nuclear Medicine and Clinical Cancer Research Center, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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5
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Dai M, Mullins CS, Lu L, Alsfasser G, Linnebacher M. Recent advances in diagnosis and treatment of gastroenteropancreatic neuroendocrine neoplasms. World J Gastrointest Surg 2022; 14:383-396. [PMID: 35734622 PMCID: PMC9160679 DOI: 10.4240/wjgs.v14.i5.383] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/17/2022] [Accepted: 04/28/2022] [Indexed: 02/06/2023] Open
Abstract
Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are a rare group of tumors originating from neuroendocrine cells of the digestive system. Their incidence has increased over the last decades. The specific pathogenetic mechanisms underlying GEP-NEN development have not been completely revealed. Unfunctional GEP-NENs are usually asymptomatic; some grow slowly and thus impede early diagnosis, which ultimately results in a high rate of misdiagnosis. Therefore, many GEP-NEN patients present with later staged tumors. Motivated hereby, research attention for diagnosis and treatment for GEP-NENs increased in recent years. The result of which is great progress in clinical diagnosis and treatment. According to the most recent clinical guidelines, improved grading standards can accurately define poorly differentiated grade 3 neuroendocrine tumors and neuroendocrine carcinomas (NECs), which are subclassified into large and small cell NECs. Combining different functional imaging methods facilitates precise diagnosis. The expression of somatostatin receptors helps to predict prognosis. Genetic analyses of mutations affecting death domain associated protein (DAXX), multiple endocrine neoplasia type 1 (MEN 1), alpha thalassemia/intellectual disability syndrome X-linked (ATRX), retinoblastoma transcriptional corepressor 1 (RB 1), and mothers against decapentaplegic homolog 4 (SMAD 4) help distinguishing grade 3 NENs from poorly differentiated NECs. The aim of this review is to summarize the latest research progress on diagnosis and treatment of GEP-NENs.
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Affiliation(s)
- Meng Dai
- Clinic of General Surgery, Molecular Oncology and Immunotherapy, Rostock University Medical Center, 18057 Rostock, Germany
| | - Christina S Mullins
- Clinic of General Surgery, Molecular Oncology and Immunotherapy, Rostock University Medical Center, 18057 Rostock, Germany
| | - Lili Lu
- Clinic of General Surgery, Molecular Oncology and Immunotherapy, Rostock University Medical Center, 18057 Rostock, Germany
| | - Guido Alsfasser
- Clinic of General Surgery, Rostock University Medical Center, 18057 Rostock, Germany
| | - Michael Linnebacher
- Clinic of General Surgery, Molecular Oncology and Immunotherapy, Rostock University Medical Center, 18057 Rostock, Germany
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6
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Shah R, Sehemby M, Garg R, Purandare N, Hira P, Mahajan A, Lele V, Malhotra G, Verma P, Rojekar A, Dalvi A, Uchino S, Rastogi S, Lila A, Patil V, Shah N, Bandgar T. 68 Ga-DOTATATE PET/CT imaging in endogenous hyperinsulinemic hypoglycemia: A tertiary endocrine centre experience. Clin Endocrinol (Oxf) 2022; 96:190-199. [PMID: 34498757 DOI: 10.1111/cen.14586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/08/2021] [Accepted: 08/10/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Literature regarding utility of 68 Ga-DOTATATE PET/CT in insulinoma localization across various subgroups [benign/malignant/multiple endocrine neoplasia-1 (MEN-1) syndrome associated] remains scarce. In this study, the performance of 68 Ga-DOTATATE PET/CT was compared with contrast-enhanced computed tomography (CECT) and 68 Ga-NODAGA-Exendin-4 PET/CT (whenever available) in an endogenous hyperinsulinemic hypoglycemia (EHH) cohort. DESIGN Retrospective audit. PATIENTS EHH patients [N = 36, lesions (n) = 49, final diagnosis: benign sporadic insulinoma (BSI) (N = 20), malignant insulinoma (N = 4, n = 14), MEN-1 syndrome associated insulinoma (N = 9, n = 15), Munchausen syndrome (N = 2) and drug-induced hypoglycemia (N = 1)] having both preoperative imaging modalities (CECT and 68 Ga-DOTATATE PET/CT). MEASUREMENTS Per-lesion sensitivity (Sn) and positive predictive value (PPV) for histopathological diagnosis of insulinoma. RESULTS Sn and PPV of 68 Ga-DOTATATE PET/CT were 67.3% and 89.2%; 55% and 100%; 85.7% and 100%; and 66.7% and 77% for overall EHH, BSI, malignant, and MEN-1 syndrome associated insulinoma cohorts respectively. Despite having comparatively lower sensitivity in BSI cohort, 68 Ga-DOTATATE PET/CT localized a pancreatic tail lesion missed by other modalities. 68 Ga-DOTATATE PET/CT had comparatively higher sensitivity in malignant insulinoma than BSI cohort. 68 Ga-DOTATATE PET/CT also paved the way for successful response to 177 Lu-based peptide receptor radionuclide therapy (PRRT). In MEN-1 cases, lower PPV as compared with BSI was due to uptake in non-insulinoma pancreatic neuroendocrine tumours (Pan-NET). CONCLUSIONS 68 Ga-DOTATATE PET/CT has supplemental role in selected cases of BSI with negative and/or discordant results with CECT and 68 Ga-NODAGA-Exendin-4 PET/CT. In malignant insulinoma, 68 Ga-DOTATATE-PET/CT has an additional theranostic potential. Interference due to uptake in non-insulinoma Pan-NET in MEN-1 syndrome may hinder insulinoma localization with 68 Ga-DOTATATE-PET/CT.
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Affiliation(s)
- Ravikumar Shah
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Mumbai, India
| | - Manjeetkaur Sehemby
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Mumbai, India
| | - Robin Garg
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Mumbai, India
| | - Nilendu Purandare
- Department of Radiodiagnosis and Imaging, Tata Memorial Center, Mumbai, India
| | - Priya Hira
- Department of Radiodiagnosis, Seth GS Medical College & KEM Hospital, Mumbai, India
| | - Abhishek Mahajan
- Department of Radiodiagnosis and Imaging, Tata Memorial Center, Mumbai, India
| | - Vikram Lele
- Department of Nuclear Medicine & PET/CT, Jaslok Hospital & Research Center, Mumbai, India
| | - Gaurav Malhotra
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre, Mumbai, India
| | - Priyanka Verma
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre, Mumbai, India
| | - Amey Rojekar
- Department of Pathology, Seth GS Medical College & KEM Hospital, Mumbai, India
| | - Abhay Dalvi
- Department of General Surgery, Seth GS Medical College & KEM Hospital, Mumbai, India
| | - Shinya Uchino
- Endocrine Surgical Department, Noguchi Thyroid Clinic and Hospital Foundation, Oita, Japan
| | - Shivam Rastogi
- Department of Radiodiagnosis and Imaging, Tata Memorial Center, Mumbai, India
| | - Anurag Lila
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Mumbai, India
| | - Virendra Patil
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Mumbai, India
| | - Nalini Shah
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Mumbai, India
| | - Tushar Bandgar
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Mumbai, India
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7
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Laffi A, Colandrea M, Buonsanti G, Frassoni S, Bagnardi V, Spada F, Pisa E, Barberis M, Rubino M, Grana CM, Ceci F, Fazio N. A Retrospective Analysis of the Correlation between Functional Imaging and Clinical Outcomes in Grade 3 Neuroendocrine Tumors (NETs G3). Diagnostics (Basel) 2021; 11:2401. [PMID: 34943637 PMCID: PMC8700454 DOI: 10.3390/diagnostics11122401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/13/2021] [Accepted: 12/17/2021] [Indexed: 12/04/2022] Open
Abstract
Grade 3 (G3) neuroendocrine tumors (NETs) are a novel category among digestive neuroendocrine neoplasms, characterized by Ki-67 >20% and a well-differentiated morphology, presenting high intra-tumor heterogeneity. We aimed to explore the role of dual-tracer PET imaging (68Gallium (Ga)-DOTATOC and 18Fluorodeoxyglucose (FDG)) as overall survival (OS) predictor in NET G3 patients. We performed a retrospective analysis in NET G3 patients treated at our institution between 2003 and 2021. Accordingly, 30 NET G3 patients were analyzed. 68Ga-DOTA-TOC and 18F-FDG uptake were assessed by tumor/non-tumor (T-nonT) ratio. We reported a slightly better OS for patients with ≥75% concordance between 68Ga-DOTA-TOC and 18F-FDG PET/CT (p = 0.42). Among patients with discordant functional imaging, we reported a better 5-y OS rate for patients with a prevalent 68Ga-DOTATOC vs. 18F-FDG PET/CT (p = 0.016). In positive 18F-FDG PET/CT cases, we reported a better OS for <4 vs. ≥4 T/non-T ratio (p = 0.021). Among upfront-NET G3 patients with concordant exams, 5-y OS rate was 83.3% (95% CI: 27.3-97.5). Among patients with discordant exams, 5-y OS rate was 81.3% (52.5-93.5), 100% for those with prevalent receptor expression, and 50% (11.1-80.4) for those with prevalent 18F-FDG uptake. Our findings suggest that dual-tracer PET/CT can be considered as a predictor of patient outcome, able to stratify NET G3 patients with poorer prognosis.
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Affiliation(s)
- Alice Laffi
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (F.S.); (M.R.); (N.F.)
| | - Marzia Colandrea
- Division of Nuclear Medicine, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (M.C.); (G.B.); (F.C.)
| | - Giuseppe Buonsanti
- Division of Nuclear Medicine, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (M.C.); (G.B.); (F.C.)
| | - Samuele Frassoni
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy; (S.F.); (V.B.)
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy; (S.F.); (V.B.)
| | - Francesca Spada
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (F.S.); (M.R.); (N.F.)
| | - Eleonora Pisa
- Division of Pathology and Laboratory Medicine, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (E.P.); (M.B.)
| | - Massimo Barberis
- Division of Pathology and Laboratory Medicine, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (E.P.); (M.B.)
| | - Manila Rubino
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (F.S.); (M.R.); (N.F.)
| | - Chiara Maria Grana
- Unit of Radiometabolic Therapy, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy;
| | - Francesco Ceci
- Division of Nuclear Medicine, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (M.C.); (G.B.); (F.C.)
| | - Nicola Fazio
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (F.S.); (M.R.); (N.F.)
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Abstract
Primary thyroid cancers demonstrate distinct biological behaviors depending on their histologic characteristics. The ability to accumulate radioiodine by differentiated thyroid cancer cells is lost in primary aggressive, poorly differentiated and dedifferentiated tumor cells. PET imaging comes into play in these challenging situations where it can provide additive information to radioiodine scintigraphy and conventional imaging. This review focuses on the current guidelines and future prospects of PET imaging in thyroid cancers.
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9
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Hou J, Long T, Yang N, Chen D, Zeng S, Zheng K, Liao G, Hu S. Biodistribution of 18F-AlF-NOTA-octreotide in Different Organs and Characterization of Uptake in Neuroendocrine Neoplasms. Mol Imaging Biol 2021; 23:827-835. [PMID: 34231107 DOI: 10.1007/s11307-021-01628-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/31/2021] [Accepted: 06/16/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE The aims of this study were threefold: [1] to describe the biodistribution of 18F-AlF-NOTA-octreotide (18F-OC) in normal organs; [2] to evaluate the range of uptake of NEN and benign lesions using the maximum standardized uptake value (SUVmax); and [3] to compare the difference in 18F-OC uptake among tumors of different grades. METHODS This study included 162 patients (67 females and 95 males) who received 18F-OC positron emission tomography (PET)/computed tomography (CT), 128 of whom were diagnosed with neuroendocrine neoplasms (NENs). The SUVmax and SUVmean of 18F-OC were measured in 21 normal anatomical structures. We compared the differences among G1, G2, and G3 NENs, as well as between NENs and benign lesions. RESULTS High physiological uptake of 18F-OC (SUVmax > 6.77) was detected in the spleen, adrenal gland, renal parenchyma, pituitary gland, and liver. Moderate uptake (SUVmax 3.00-6.77) was found in the uncinate process of the pancreas (PU), prostate, thyroid, and uterus. Mild uptake (SUVmax 1.34-3.00) was observed in the small intestine, pancreas (pancreas uptake except for the head of the pancreas), gallbladder, and transverse colon. The SUVmax of NENs was higher than that of benign lesions, including fractures, inflamed tissue, reactive hyperplasia, and degenerative disease. However, overlap was noted between the two groups. The SUVmax of 18F-OC uptake by tumors was significantly correlated with tumor grade in primary lesions and those of the lymph node, bone, and other sites (all P < 0.01). CONCLUSIONS The results obtained from the majority of the samples in this study show the biodistribution of 18F-OC in normal organs and have significance as a reference. Although some benign lesions show variable uptake, the uptake by these lesions is still different from that of NENs. NENs of different grades have differences in 18F-OC uptake levels.
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Affiliation(s)
- Jiale Hou
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan Province, People's Republic of China
| | - Tingting Long
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan Province, People's Republic of China
| | - Nengan Yang
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan Province, People's Republic of China
| | - Dengming Chen
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan Province, People's Republic of China
| | - Shan Zeng
- Department of Oncology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan Province, People's Republic of China
| | - Kai Zheng
- Department of PET/CT Center, Hunan Cancer Hospital, No. 283 Tongzipo Road, Changsha, Hunan Province, 410013, People's Republic of China.,Department of PET/CT Center, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, No. 283 Tongzipo Road, Changsha, Hunan Province, 410013, People's Republic of China
| | - Guang Liao
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan Province, People's Republic of China
| | - Shuo Hu
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan Province, People's Republic of China. .,Key laboratory of biological nanotechnology of National Health Commission, No. 87 Xiangya Road, Changsha, Hunan Province, 410008, People's Republic of China. .,National Clinical Research Center for Geriatric Disorders (XIANGYA), Central South University, Changsha, 410008, Hunan, China.
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10
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Abstract
Several studies have demonstrated the effectiveness of somatostatin receptor (SSTR)-targeted imaging for diagnosis, staging, evaluating the possibility of treatment with cold somatostatin analogs, as well peptide receptor radionuclide therapy (PRRT), and evaluation of treatment response. PET with 68Ga-labeled somatostatin analogs provides excellent sensitivity and specificity for diagnosing and staging neuroendocrine tumors (NETs). Metabolic imaging with PET with fludeoxyglucose 18F/computed tomography (CT) complements the molecular imaging with 68Ga-SSTR PET/CT toward a personalized therapy in NET patients. The documented response rate of PRRT in NET summing up complete response, partial response, minor response, and stable disease is 70% to 80%.
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Affiliation(s)
- Margarida Rodrigues
- Department of Nuclear Medicine, Medical University of Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria.
| | - Hanna Svirydenka
- Department of Nuclear Medicine, Medical University of Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria
| | - Irene Virgolini
- Department of Nuclear Medicine, Medical University of Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria
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11
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Arslan E, Çermik TF. PET/CT Variants and Pitfalls in Liver, Biliary Tract, Gallbladder and Pancreas. Semin Nucl Med 2021; 51:502-518. [PMID: 34049687 DOI: 10.1053/j.semnuclmed.2021.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A wide variety of pathological anomalies may occur in the liver, biliary system, and pancreas. It is a necessity to use many different imaging techniques in order to distinguish such varied pathologies, especially those from malignant processes. Positron Emission Tomography/Computed Tomography (PET/CT) is an imaging method that has proven its diagnostic value in oncology and can be used for different clinical purposes. Fluoro-18 fluoro-2-deoxy-D-glucose has a wide range of uses as a dominant radiopharmaceutical in routine molecular imaging, however, molecular imaging has started to play a more important role in personalized cancer treatment in recent years with new Fluoro-18 and Gallium-68 labeled tracers. Although molecular imaging has a strong diagnostic effect, the surprises and pitfalls of molecular imaging can lead us to unexpected and misleading results. Prior to PET/CT analysis and reporting, information about possible technical and physiological pitfalls, normal histological features of tissues, inflammatory pathologies, specific clinical features of the case, treatment-related complications and past treatments should be evaluated in advance to avoid misinterpretation. In this review, the physiological and pathophysiological variants as well as pitfalls encountered in PET/CT imaging of the liver, biliary tract, gallbladder, and pancreas will be examined. Other benign and malignant pathologies that have been reported to date and that have led to incorrect evaluation will be listed. It is expected that the devices, software, and artificial intelligence applications that will be developed in the near future will enable much more effective and faster imaging that will reduce the potential causes of error. However, as a result of the dynamic and evolving structure of the information obtained by molecular imaging, the inclusion of the newly developed radiopharmaceuticals in routine practice will continue to carry new potentials as well as new troubles. Although molecular imaging will be the flagship of diagnostic oncology in the 21st century, the correct analysis and interpretation by the physician will continue to form the basis of achieving optimal performance.
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Affiliation(s)
- Esra Arslan
- Istanbul Training and Research Hospital, Clinic of Nuclear Medicine, University of Health and Sciences Turkey, Istanbul, Turkey.
| | - Tevfik Fikret Çermik
- Istanbul Training and Research Hospital, Clinic of Nuclear Medicine, University of Health and Sciences Turkey, Istanbul, Turkey
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12
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Yoo J, Kim SH, Jeon SK, Bae JS, Han JK. Added value of [ 68Ga]Ga-DOTA-TOC PET/CT for characterizing pancreatic neuroendocrine neoplasms: a comparison with contrast-enhanced CT and/or MRI in a large study cohort. Eur Radiol 2021; 31:7734-7745. [PMID: 33787974 DOI: 10.1007/s00330-021-07859-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 02/14/2021] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To investigate an additional value of [68Ga]Ga-DOTA-TOC PET/CT for characterizing suspected pancreatic neuroendocrine neoplasms (NENs) in a large study cohort. METHODS This retrospective study included 167 patients who underwent [68Ga]Ga-DOTA-TOC PET/CT for suspected pancreatic NENs detected by contrast-enhanced CT (n = 153) and/or MRI (n = 85). Two board-certified radiologists independently reviewed CT and/or MRI as well as [68Ga]Ga-DOTA-TOC PET/CT and scored the probability of NEN on a 5-point scale. Radiologists' diagnostic performances with and without [68Ga]Ga-DOTA-TOC PET/CT were compared using pathologic findings as the standard of reference. RESULTS All 167 patients were pathologically diagnosed with NENs (n = 131) or non-NENs (n = 36) by surgery (n = 93) or biopsy (n = 74). The non-NEN group included focal pancreatitis (n = 7), gastrointestinal stromal tumor (n = 6), serous cystadenoma (n = 5), metastatic renal cell carcinoma (n = 4), intrapancreatic accessory spleen (n = 4), ductal adenocarcinoma (n = 3), solid pseudopapillary neoplasm (n = 2), intraductal papillary mucinous carcinoma (n = 1), adenosquamous carcinoma (n = 1), schwannoma (n = 1), paraganglioma (n = 1), and solitary fibrous tumor (n = 1). Radiologists' diagnostic performance significantly improved after the addition of [68Ga]Ga-DOTA-TOC PET/CT (AUC of CT: 0.737 vs. 0.886 for reviewer 1 [p = 0.0004]; 0.709 vs. 0.859 for reviewer 2 [p = 0.0002], AUC of MRI: 0.748 vs. 0.872 for reviewer 1 [p = 0.023]; 0.670 vs. 0.854 for reviewer 2 [p = 0.001]). [68Ga]Ga-DOTA-TOC PET/CT significantly improved sensitivity (CT: 87.4% vs. 96.6% for reviewer 1 [p = 0.001]; 74.8% vs. 92.5% for reviewer 2 [p = 0.0001], MRI: 86.9% vs. 98.4% for reviewer 1 [p = 0.016]; 70.5% vs. 91.8% for reviewer 2 [p = 0.002]). CONCLUSIONS [68Ga]Ga-DOTA-TOC PET/CT provided an additional value over conventional CT or MRI for the characterization of suspected pancreatic NENs. KEY POINTS • [68Ga]Ga-DOTA-TOC PET/CT could provide additional value over conventional CT and/or MRI for the exact characterization of suspected pancreatic NENs by increasing AUC values and sensitivity. • Diagnostic improvement was significant, especially in NENs showing an atypical enhancement pattern. • The inter-observer agreement was improved when [68Ga]Ga-DOTA-TOC PET/CT was added to CT and/or MRI.
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Affiliation(s)
- Jeongin Yoo
- Department of Radiology, Seoul National University Hospital, 101 Daehakro, Jongno-gu, Seoul, 110-744, Korea
| | - Se Hyung Kim
- Department of Radiology, Seoul National University Hospital, 101 Daehakro, Jongno-gu, Seoul, 110-744, Korea. .,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea. .,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.
| | - Sun Kyung Jeon
- Department of Radiology, Seoul National University Hospital, 101 Daehakro, Jongno-gu, Seoul, 110-744, Korea
| | - Jae Seok Bae
- Department of Radiology, Seoul National University Hospital, 101 Daehakro, Jongno-gu, Seoul, 110-744, Korea
| | - Joon Koo Han
- Department of Radiology, Seoul National University Hospital, 101 Daehakro, Jongno-gu, Seoul, 110-744, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
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13
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Garg R, Shah R, Tiwari A, Purandare N, Lele VR, Malhotra G, Verma P, Gosavi V, Dalvi A, Kumar Jaiswal S, Patil V, Ramteke-Jadhav S, Lila A, Shah N, Bandgar T. Exendin-4-based imaging in endogenous hyperinsulinemic hypoglycaemia cohort: A tertiary Endocrine centre experience. Clin Endocrinol (Oxf) 2020; 93:678-686. [PMID: 32716527 DOI: 10.1111/cen.14299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/08/2020] [Accepted: 07/12/2020] [Indexed: 12/11/2022]
Abstract
CONTEXT Insulinoma needs accurate preoperative localization for minimally invasive surgery. Exendin-4-based imaging has shown promising results. OBJECTIVE To evaluate performance parameters of exendin-4-based imaging in insulinoma localization and compare with other imaging modalities. DESIGN Retrospective cross-sectional study. PATIENTS We report 14 patients with endogenous hyperinsulinemic hypoglycaemia (EHH) managed at our centre; in whom, the final diagnosis was insulinoma (n = 11), Munchausen syndrome (MS) (n = 2) and inconclusive (n = 1). Retrospective reporting of CECT, 68 Ga-DOTATATE PET/CT and 68 Ga-NODAGA-exendin-4-PET/CT was done. With per-lesion analysis, performance parameters were calculated for the histopathological diagnosis of insulinoma. MAIN OUTCOME MEASURES True positive (TP), false positive (FP), false negative (FN), true negative (TN), sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) for insulinoma localization. RESULTS In our cohort, 12 histopathologically proven insulinoma lesions [(TP): 11 primary lesions, 1 metastasis] were detected in 11 patients, whereas two patients had MS (TN). Sn and PPV were 75% and 100%, 33.3% and 80% and 83.3% and 71.4% for CECT, 68 Ga-DOTATATE PET/CT and 68 Ga-NODAGA-exendin-4-PET/CT, respectively. With exendin-4-based imaging, FP uptake in normal pancreatic tissue and FN results in the pancreatic tail lesion was seen. In one patient, TN result suggested the correct diagnosis of MS. CONCLUSION 68 Ga-NODAGA-exendin-4-PET/CT has higher sensitivity than 68 Ga-DOTATATE PET/CT and CECT for insulinoma localization. FP uptake in normal pancreas and FN result in tail lesions are limitations of currently utilized exendin-4-based imaging.
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Affiliation(s)
- Robin Garg
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, India
| | - Ravikumar Shah
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, India
| | - Ankita Tiwari
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, India
| | - Nilendu Purandare
- Department of Radiodiagnosis and Imaging, Tata Memorial Center, Mumbai, India
| | - Vikram R Lele
- Department of Nuclear Medicine & PET/CT, Jaslok Hospital & Research Center, Mumbai, India
| | - Gaurav Malhotra
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre, Annexe, India
| | - Priyanka Verma
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre, Annexe, India
| | - Vikrant Gosavi
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, India
| | - Abhay Dalvi
- Department of General Surgery, Seth GS Medical College & KEM Hospital, Parel, India
| | | | - Virendra Patil
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, India
| | - Swati Ramteke-Jadhav
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, India
| | - Anurag Lila
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, India
| | - Nalini Shah
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, India
| | - Tushar Bandgar
- Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, India
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14
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Abstract
PURPOSE OF REVIEW Ectopic adrenocorticotropic hormone (ACTH)-secreting tumors are commonly small, yet they often lead to fulminant forms of Cushing syndrome. High-resolution functional imaging modalities, such as [Ga]-DOTATATE, have been recently introduced in clinical practice for the identification of neuroendocrine tumors. In this review, we focus on the performance of [Ga]-DOTATATE as a tool for localizing primary and metastatic sources of ectopic Cushing syndrome (ECS). RECENT FINDINGS Prompt surgical removal of ectopic ACTH-secreting tumors is the mainstay of therapy in patients with ECS. Detecting such tumors with conventional cross-sectional imaging is often unsuccessful, owing to their small size. [Ga]-DOTATATE has been approved in 2016 by the Federal Drug Administration for imaging well differentiated neuroendocrine tumors. Data regarding the performance of [Ga]-DOTATATE for detecting ectopic ACTH-secreting tumors remain limited, in part owing to the recent introduction of this imaging modality in clinical practice, and in part because of the low prevalence of ECS. Nevertheless, [Ga]-DOTATATE has been reported to be useful in identifying primary and metastatic ectopic ACTH-secreting lesions that were not apparent on other imaging studies, impacting the clinical care of many patients with ECS. SUMMARY [Ga]-DOTATATE-based imaging, which targets the somatostatin receptors abundantly expressed in neuroendocrine tumors, has generally high, although variable resolution in detecting the source(s) of ECS.
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Affiliation(s)
- Seda Grigoryan
- Department of Internal Medicine, Michigan State University, East Lasing
| | | | - Adina F Turcu
- Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan, USA
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15
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Xia Y, Zeng C, Zhao Y, Zhang X, Li Z, Chen Y. Comparative evaluation of 68Ga-labelled TATEs: the impact of chelators on imaging. EJNMMI Res 2020; 10:36. [PMID: 32297029 PMCID: PMC7158967 DOI: 10.1186/s13550-020-00620-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/19/2020] [Indexed: 01/01/2023] Open
Abstract
Background 68Ga-labelled peptides targeting somatostatin receptor 2 (SSTR2) have demonstrated encouraging results in managing patients with neuroendocrine tumours (NETs). In addition to metal chelation, bifunctional chelators have also been found to impact imaging outcomes due to their differences in stability, charge, hydrophilicity, etc. In the present work, a comparative pharmacokinetic evaluation and imaging characteristics were performed between 68Ga-labelled somatostatin analogues (TATE) using NOTA (1,4,7-triazacyclononane-1,4,7-triacetic acid) and DOTA (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid) as bifunctional chelating agents (BFCAs). Results Both 68Ga-NOTA-TATE and 68Ga-DOTA-TATE were obtained with high radiochemical purity. 68Ga-NOTA-TATE demonstrated higher in vitro stability (≥ 99%) than 68Ga-DOTA-TATE (≥ 95%) after 3 h of incubation. The water solubilities (partition coefficients, − 1.76 ± 0.06 vs. − 2.72 ± 0.16) and plasma protein binding rates (12.12% vs. 30.6%) were lower for 68Ga-NOTA-TATE than for 68Ga-DOTA-TATE. Differential pharmacokinetics and comparable tumour affinities (within 1 h) were observed in AR42J tumour-bearing mice. Healthy volunteer imaging studies showed comparable distribution patterns of these two imaging agents. However, the maximum standardized uptake values (SUVmax) of the two tracers varied in each organ. The two PET agents demonstrated almost identical SUVmax values in the kidneys. 68Ga-NOTA-TATE did have a lower SUVmax in most other organs compared with 68Ga-DOTA-TATE, including the liver (4.2 vs. 10.1), potentially due to the lower protein binding rate. Conclusion 68Ga-NOTA-TATE and 68Ga-DOTA-TATE demonstrated comparable tumour uptake in an AR42J mouse model. An initial clinical study revealed that 68Ga-NOTA-TATE may have reduced background uptake in the major organs such as the liver. Although the subject numbers were limited, further investigation of 68Ga-NOTA-TATE is warranted for detecting SSTR2-positive neuroendocrine tumours.
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Affiliation(s)
- Yuxiao Xia
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No. 25, Taiping St, Luzhou, 646000, Sichuan, People's Republic of China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, No. 25, Taiping St, Luzhou, 646000, Sichuan, People's Republic of China
| | - Chengrun Zeng
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No. 25, Taiping St, Luzhou, 646000, Sichuan, People's Republic of China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, No. 25, Taiping St, Luzhou, 646000, Sichuan, People's Republic of China
| | - Yanhong Zhao
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No. 25, Taiping St, Luzhou, 646000, Sichuan, People's Republic of China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, No. 25, Taiping St, Luzhou, 646000, Sichuan, People's Republic of China
| | - Xinyi Zhang
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No. 25, Taiping St, Luzhou, 646000, Sichuan, People's Republic of China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, No. 25, Taiping St, Luzhou, 646000, Sichuan, People's Republic of China
| | - Zibo Li
- Biomedical Research Imaging Center, Department of Radiology, and UNC Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, Chapel Hill, NC, 27514, USA.
| | - Yue Chen
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No. 25, Taiping St, Luzhou, 646000, Sichuan, People's Republic of China. .,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, No. 25, Taiping St, Luzhou, 646000, Sichuan, People's Republic of China.
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16
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Rozenblum L, Mokrane FZ, Yeh R, Sinigaglia M, Besson FL, Seban RD, Zadro C, Dierickx L, Chougnet CN, Partouche E, Revel-Mouroz P, Zhao B, Otal P, Schwartz LH, Dercle L. Imaging-guided precision medicine in non-resectable gastro-entero-pancreatic neuroendocrine tumors: A step-by-step approach. Eur J Radiol 2020; 122:108743. [DOI: 10.1016/j.ejrad.2019.108743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 11/11/2019] [Indexed: 12/11/2022]
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17
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Howe JR, Merchant NB, Conrad C, Keutgen XM, Hallet J, Drebin JA, Minter RM, Lairmore TC, Tseng JF, Zeh HJ, Libutti SK, Singh G, Lee JE, Hope TA, Kim MK, Menda Y, Halfdanarson TR, Chan JA, Pommier RF. The North American Neuroendocrine Tumor Society Consensus Paper on the Surgical Management of Pancreatic Neuroendocrine Tumors. Pancreas 2020; 49:1-33. [PMID: 31856076 PMCID: PMC7029300 DOI: 10.1097/mpa.0000000000001454] [Citation(s) in RCA: 231] [Impact Index Per Article: 46.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This manuscript is the result of the North American Neuroendocrine Tumor Society consensus conference on the surgical management of pancreatic neuroendocrine tumors from July 19 to 20, 2018. The group reviewed a series of questions of specific interest to surgeons taking care of patients with pancreatic neuroendocrine tumors, and for each, the available literature was reviewed. What follows are these reviews for each question followed by recommendations of the panel.
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Affiliation(s)
- James R. Howe
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA
| | | | - Claudius Conrad
- Department of Surgery, St. Elizabeth Medical Center, Tufts University School of Medicine, Boston, MA
| | | | - Julie Hallet
- Department of Surgery, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Jeffrey A. Drebin
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Rebecca M. Minter
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | | | | | - Herbert J. Zeh
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Steven K. Libutti
- §§ Department of Surgery, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Gagandeep Singh
- Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Jeffrey E. Lee
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Thomas A. Hope
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA
| | - Michelle K. Kim
- Department of Medicine, Mt. Sinai Medical Center, New York, NY
| | - Yusuf Menda
- Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, IA
| | | | - Jennifer A. Chan
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Rodney F. Pommier
- Department of Surgery, Oregon Health & Sciences University, Portland, OR
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18
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Vija L, Dierickx L, Courbon F. Receptor radionuclide targeting for neuroendocrine tumors (NET) diagnostic and therapy. ANNALES D'ENDOCRINOLOGIE 2019; 80:166-171. [PMID: 31053248 DOI: 10.1016/j.ando.2019.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Neuroendocrine tumors (NET) represent a heterogeneous group of tumors originating from cells of neuroendocrine origin, which express somatostatin receptors (SSTR). This property allowed the successful development of radionuclides for diagnostic and peptide radionuclide radiation therapy (PRRT). This is the paradigm for the theragnostic concept in NET personalized medicine. The only phase III study to date (NETTER-1) clearly demonstrated the ability of 177Lutetium-based PRRT to improve progression-free survival in advanced intestinal NETs. In clinical practice, the indications are limited to G1-G2 well-differentiated NETs with high expression of SSTR. NETs with a low tumor burden and slow progression are probably the optimal indication. This treatment is now available in France. However, its precise position in the treatment algorithm remains to be explored. We provide an overview of receptor radionuclide utilization and mechanism in diagnostic and pretherapeutic imaging and we focus on PRRT for endocrine tumors.
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Affiliation(s)
- Lavinia Vija
- Service de médecine nucléaire, institut universitaire du cancer Toulouse-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - Lawrence Dierickx
- Service de médecine nucléaire, institut universitaire du cancer Toulouse-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - Frederic Courbon
- Service de médecine nucléaire, institut universitaire du cancer Toulouse-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France; Centre de recherche en cancérologie de Toulouse, UMR 1037, équipe n(o) 12 « métabolisme des stérols et innovations thérapeutiques en oncologie », 31100 Toulouse, France.
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19
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Ivanidze J, Roytman M, Sasson A, Skafida M, Fahey TJ, Osborne JR, Dutruel SP. Molecular imaging and therapy of somatostatin receptor positive tumors. Clin Imaging 2019; 56:146-154. [PMID: 31121520 DOI: 10.1016/j.clinimag.2019.04.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 04/13/2019] [Indexed: 01/28/2023]
Abstract
Somatostatin receptors (SSTR) are upregulated in the cells of origin that define numerous neuroendocrine neoplasms. PET imaging with 68Ga-DOTATATE allows specific targeting of SSTR2A, a single species of SSTR receptor, which is commonly overexpressed in a variety of gastroenteropancreatic neuroendocrine tumors, as well as pulmonary carcinoid and head and neck tumors. Due to more specific targeting of SSTR2 as well as lower radiation dose, shorter study length, ability to quantify uptake, and lower cost, 68Ga-DOTATATE has demonstrated superior imaging attributes when compared to 111In-pentetreotide. As with any novel imaging modality, dedicated training, increasing experience and staying up-to-date with scientific publications are required to provide optimal patient care. The purpose of this review is to summarize the current state of the art in SSTR-targeted molecular imaging and discuss ongoing and future potential diagnostic and therapeutic applications.
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Affiliation(s)
- Jana Ivanidze
- New York-Presbyterian Hospital/Weill Cornell Medical Center, United States of America
| | - Michelle Roytman
- New York-Presbyterian Hospital/Weill Cornell Medical Center, United States of America
| | | | - Myrto Skafida
- New York-Presbyterian Hospital/Weill Cornell Medical Center, United States of America
| | - Thomas J Fahey
- New York-Presbyterian Hospital/Weill Cornell Medical Center, United States of America
| | - Joseph R Osborne
- New York-Presbyterian Hospital/Weill Cornell Medical Center, United States of America
| | - Silvina P Dutruel
- New York-Presbyterian Hospital/Weill Cornell Medical Center, United States of America.
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20
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Enchondroma of Tibia as Potential False-positive Finding on 68Ga-DOTATOC PET/CT Scan. Clin Nucl Med 2019; 44:e57-e59. [DOI: 10.1097/rlu.0000000000002360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Kan Y, Zhang S, Wang W, Liu J, Yang J, Wang Z. 68Ga-somatostatin receptor analogs and 18F-FDG PET/CT in the localization of metastatic pheochromocytomas and paragangliomas with germline mutations: a meta-analysis. Acta Radiol 2018; 59:1466-1474. [PMID: 29566550 DOI: 10.1177/0284185118764206] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Metastatic pheochromocytoma and paraganglioma (PCs/PGLs) show high germline mutation, and 18F-FDG and 68Ga-DOTA peptide positron emission tomography/computed tomography (PET/CT) imaging are recommended for the diagnosis of metastatic of PCs. However, there has been lack of direct comparison of the two modalities in the diagnosis of metastatic of PCs up to now. PURPOSE To evaluate and compare the value of localization of 68Ga-somatostatin receptor analogs and 18F-FDG in the diagnosis of metastatic PCs/PGLs. MATERIAL AND METHODS A comprehensive literature search of PubMed/MEDLINE, ScienceDirect, and Web of Science was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines published in August 2016. We critically reviewed all studies based on the PICOS criteria. QUADAS-2 was used to evaluate the quality of the methodology of the included studies. RESULTS This meta-analysis included 17 studies (629 patients, average age [mean ± SD] = 42.7 ± 6.3 years). The pooled sensitivity and specificity of 18F-FDG and 68Ga peptides were 0.85 (95% confidence interval [CI] = 0.78-0.91) and 0.55 (95% CI = 0.37-0.73), and 0.95 (95% CI = 0.92-0.97) and 0.87 (95% CI = 0.63-0.96), respectively. The area under the sROC curves of the 18F-FDG and 68Ga peptides were 0.88 (95% CI = 0.85-0.91) and 0.78 (95% CI = 0.74-0.81), respectively. A subgroup analysis demonstrated that the difference at the per-lesion level and gene mutation level was significant. CONCLUSION Compared to 18F-FDG PET/CT, the 68Ga-somatostatin receptor demonstrated good performance in the localization of metastatic PCs/PGLs, especially those with germline mutations. The use of the 68Ga-somatostatin receptor can be a new tool in the diagnosis of metastatic PCs/PGLs.
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Affiliation(s)
- Ying Kan
- Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Shuxin Zhang
- Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Wei Wang
- Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Jie Liu
- Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Jigang Yang
- Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
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22
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Werner RA, Weich A, Kircher M, Solnes LB, Javadi MS, Higuchi T, Buck AK, Pomper MG, Rowe SP, Lapa C. The theranostic promise for Neuroendocrine Tumors in the late 2010s - Where do we stand, where do we go? Theranostics 2018; 8:6088-6100. [PMID: 30613284 PMCID: PMC6299695 DOI: 10.7150/thno.30357] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 10/24/2018] [Indexed: 12/14/2022] Open
Abstract
More than 25 years after the first peptide receptor radionuclide therapy (PRRT), the concept of somatostatin receptor (SSTR)-directed imaging and therapy for neuroendocrine tumors (NET) is seeing rapidly increasing use. To maximize the full potential of its theranostic promise, efforts in recent years have expanded recommendations in current guidelines and included the evaluation of novel theranostic radiotracers for imaging and treatment of NET. Moreover, the introduction of standardized reporting framework systems may harmonize PET reading, address pitfalls in interpreting SSTR-PET/CT scans and guide the treating physician in selecting PRRT candidates. Notably, the concept of PRRT has also been applied beyond oncology, e.g. for treatment of inflammatory conditions like sarcoidosis. Future perspectives may include the efficacy evaluation of PRRT compared to other common treatment options for NET, novel strategies for closer monitoring of potential side effects, the introduction of novel radiotracers with beneficial pharmacodynamic and kinetic properties or the use of supervised machine learning approaches for outcome prediction. This article reviews how the SSTR-directed theranostic concept is currently applied and also reflects on recent developments that hold promise for the future of theranostics in this context.
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Affiliation(s)
- Rudolf A. Werner
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Nuclear Medicine/Comprehensive Heart Failure Center, University Hospital Würzburg, Germany
- European Neuroendocrine Tumor Society (ENETS) Center of Excellence (CoE), NET Zentrum, University Hospital Würzburg, Germany
| | - Alexander Weich
- European Neuroendocrine Tumor Society (ENETS) Center of Excellence (CoE), NET Zentrum, University Hospital Würzburg, Germany
- Department of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Germany
| | - Malte Kircher
- Department of Nuclear Medicine/Comprehensive Heart Failure Center, University Hospital Würzburg, Germany
- European Neuroendocrine Tumor Society (ENETS) Center of Excellence (CoE), NET Zentrum, University Hospital Würzburg, Germany
| | - Lilja B. Solnes
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mehrbod S. Javadi
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Takahiro Higuchi
- Department of Nuclear Medicine/Comprehensive Heart Failure Center, University Hospital Würzburg, Germany
- Department of Bio Medical Imaging, National Cardiovascular and Cerebral Research Center, Suita, Japan
| | - Andreas K. Buck
- Department of Nuclear Medicine/Comprehensive Heart Failure Center, University Hospital Würzburg, Germany
- European Neuroendocrine Tumor Society (ENETS) Center of Excellence (CoE), NET Zentrum, University Hospital Würzburg, Germany
| | - Martin G. Pomper
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Steven P. Rowe
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Constantin Lapa
- Department of Nuclear Medicine/Comprehensive Heart Failure Center, University Hospital Würzburg, Germany
- European Neuroendocrine Tumor Society (ENETS) Center of Excellence (CoE), NET Zentrum, University Hospital Würzburg, Germany
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23
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Ramage J, Naraev BG, Halfdanarson TR. Peptide receptor radionuclide therapy for patients with advanced pancreatic neuroendocrine tumors. Semin Oncol 2018; 45:236-248. [DOI: 10.1053/j.seminoncol.2018.08.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 08/22/2018] [Indexed: 01/14/2023]
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24
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Lin M, Waligorski GJ, Lepera CG. Production of curie quantities of 68Ga with a medical cyclotron via the 68Zn(p,n)68Ga reaction. Appl Radiat Isot 2018; 133:1-3. [DOI: 10.1016/j.apradiso.2017.12.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 11/29/2017] [Accepted: 12/08/2017] [Indexed: 12/22/2022]
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25
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Monazzam A, Lau J, Velikyan I, Li SC, Razmara M, Rosenström U, Eriksson O, Skogseid B. Increased Expression of GLP-1R in Proliferating Islets of Men1 Mice is Detectable by [ 68Ga]Ga-DO3A-VS-Cys 40-Exendin-4 /PET. Sci Rep 2018; 8:748. [PMID: 29335487 PMCID: PMC5768696 DOI: 10.1038/s41598-017-18855-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 12/13/2017] [Indexed: 12/22/2022] Open
Abstract
Multiple endocrine neoplasia type 1 (MEN1) is an endocrine tumor syndrome caused by heterozygous mutations in the MEN1 tumor suppressor gene. The MEN1 pancreas of the adolescent gene carrier frequently contain diffusely spread pre-neoplasias and microadenomas, progressing to macroscopic and potentially malignant pancreatic neuroendocrine tumors (P-NET), which represents the major death cause in MEN1. The unveiling of the molecular mechanism of P-NET which is not currently understood fully to allow the optimization of diagnostics and treatment. Glucagon-like peptide 1 (GLP-1) pathway is essential in islet regeneration, i.e. inhibition of β-cell apoptosis and enhancement of β-cell proliferation, yet involvement of GLP-1 in MEN1 related P-NET has not yet been demonstrated. The objective of this work was to investigate if normal sized islets of Men1 heterozygous mice have increased Glucagon-like peptide-1 receptor (GLP-1R) expression compared to wild type islets, and if this increase is detectable in vivo with positron emission tomography (PET) using [68Ga]Ga-DO3A-VS-Cys40-Exendin-4 (68Ga-Exendin-4). 68Ga-Exendin-4 showed potential for early lesion detection in MEN1 pancreas due to increased GLP1R expression.
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Affiliation(s)
- Azita Monazzam
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Joey Lau
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Irina Velikyan
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Su-Chen Li
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Masoud Razmara
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Ulrika Rosenström
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Olof Eriksson
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Britt Skogseid
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
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26
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Schwartz P, Ceyrat Q, Hindié E, Fernandez P, Bordenave L, Pinaquy JB. Fréquence de la fixation physiologique de l’uncus pancréatique en scintigraphie à l’ 111 In-pentétréotide : étude rétrospective chez 198 patients. MÉDECINE NUCLÉAIRE 2017; 41:405-414. [DOI: 10.1016/j.mednuc.2017.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2025]
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Bodei L, Ambrosini V, Herrmann K, Modlin I. Current Concepts in 68Ga-DOTATATE Imaging of Neuroendocrine Neoplasms: Interpretation, Biodistribution, Dosimetry, and Molecular Strategies. J Nucl Med 2017; 58:1718-1726. [DOI: 10.2967/jnumed.116.186361] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/27/2017] [Indexed: 12/19/2022] Open
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28
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Ayati N, Lee ST, Zakavi R, Pathmaraj K, Al-Qatawna L, Poon A, Scott AM. Long-Acting Somatostatin Analog Therapy Differentially Alters 68Ga-DOTATATE Uptake in Normal Tissues Compared with Primary Tumors and Metastatic Lesions. J Nucl Med 2017; 59:223-227. [PMID: 28729431 DOI: 10.2967/jnumed.117.192203] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 06/28/2017] [Indexed: 12/17/2022] Open
Abstract
Synthetic somatostatin analogs have been posed as a potential source of error in somatostatin receptor imaging through interference with tumor detection; however, experimental models and clinical studies have shown a complex mechanism of the effect of octreotide on tumors. The aim of this study was to assess whether 68Ga-DOTATATE uptake before treatment with long-acting somatostatin analogs differs from that after treatment. Methods: Thirty patients (15 men; age [mean ± SD], 64.6 ± 13.4 y) who had intermediately differentiated to well-differentiated neuroendocrine tumors and who underwent 68Ga-DOTATATE PET/CT scanning before and after receiving long-acting repeatable octreotide (Sandostatin LAR) were included in the study. The SUVmax and SUVmean of healthy target organs, residual primary tumor, and up to 5 lesions with the highest SUVmax in each organ were compared before and after octreotide treatment. Results: The mean time interval between the 2 68Ga-DOTATATE studies was 9.6 ± 7.2 mo, and the mean time gap between the last Sandostatin LAR injection and the second 68Ga-DOTATATE study was 25.1 ± 14.8 d. The pretreatment mean SUVmax and SUVmean were both significantly higher in the thyroid, liver, and spleen (P < 0.05) than the values measured after the administration of Sandostatin LAR. No significant differences were found among the uptake indices for residual primary tumor or any metastatic lesions in the liver, bone, lung, or lymph nodes before and after Sandostatin LAR administration (P > 0.05). Conclusion: Long-acting octreotide treatment diminished 68Ga-DOTATATE uptake in the liver, spleen, and thyroid but did not compromise tracer uptake in residual primary tumor and metastatic lesions. These findings have a direct impact on the interpretation of 68Ga-DOTATATE PET/CT scans.
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Affiliation(s)
- Narjess Ayati
- Nuclear Medicine Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sze Ting Lee
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, Victoria, Australia
| | - Rasoul Zakavi
- Nuclear Medicine Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kunthi Pathmaraj
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, Victoria, Australia
| | - Louai Al-Qatawna
- Nuclear Medicine and Cyclotron Unit, King Hussein Medical Center, Jordanian Royal Medical Services, Amman, Jordan
| | - Aurora Poon
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, Victoria, Australia
| | - Andrew M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, Victoria, Australia .,Olivia Newton-John Cancer Research Institute, and School of Cancer Medicine, La Trobe University, Melbourne, Australia; and.,Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
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29
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Guideline for PET/CT imaging of neuroendocrine neoplasms with 68Ga-DOTA-conjugated somatostatin receptor targeting peptides and 18F–DOPA. Eur J Nucl Med Mol Imaging 2017; 44:1588-1601. [DOI: 10.1007/s00259-017-3728-y] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 05/09/2017] [Indexed: 12/15/2022]
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