In:
Clinical Nuclear Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. 1 ( 2022-1), p. 26-35
Abstract:
Gastroenteropancreatic neuroendocrine neoplasms (GEP NEN) are widely heterogeneous in their biological behavior, and predicting prognosis and optimal treatment strategies can be challenging. 68 Ga-DOTATATE PET/CT is a sensitive imaging modality for well-differentiated NEN and indicates a favorable prognosis, whereas 18 F-FDG PET/CT avidity indicates disease that is potentially more aggressive. There has been emerging interest in the combined interpretation of 68 Ga-DOTATATE and 18 F-FDG PET and its prognostic significance. We aimed to assess the prognostic utility of a classification system that incorporates the complex findings of 68 Ga-DOTATATE and 18 F-FDG PET interpreted side-by-side in patients with metastatic GEP NEN. Methods We defined 3 68 Ga-DOTATATE/ 18 F-FDG “dual-tracer PET” groups: D1 ( 68 Ga-DOTATATE positive/ 18 F-FDG negative), D2 ( 68 Ga-DOTATATE positive/ 18 F-FDG positive), and D3 ( 68 Ga-DOTATATE negative/ 18 F-FDG positive). We retrospectively assessed the association between the dual-tracer PET classification and progression-free and overall survival (OS) using Kaplan-Meier analysis. Univariate and multivariate analyses were performed using the Cox proportional hazards model. Results Eighty-seven patients with metastatic GEP NEN and contemporaneous 68 Ga-DOTATATE and 18 F-FDG PET were included. The dual-tracer PET classification was an independent predictor of OS (multivariate P = 0.016) and also predicted progression-free survival (univariate P = 0.030). Other independent predictors of OS included chromogranin A and World Health Organization (WHO) grade. WHO grade was not associated with OS from the time of dual-tracer PET but was an independent predictor of OS from the date of histological diagnosis (multivariate P = 0.003). Conclusion Our study demonstrates that a classification system combining the complex findings of 68 Ga-DOTATATE and 18 F-FDG PET is correlated with prognosis. Further research is needed to prospectively validate these findings and to explore whether dual-tracer PET scores may also be able to predict response to treatment.
Type of Medium:
Online Resource
ISSN:
1536-0229
,
0363-9762
DOI:
10.1097/RLU.0000000000003937
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2022
detail.hit.zdb_id:
2045053-9
