Abstract
Introduction: Somatostatin receptor (SSTR) imaging is widely used for guiding the management of neuroendocrine tumor (NET) patients. 68Ga-DOTATATE approval by the US Food and Drug Administration has triggered widespread clinical interest in SSTR Positron Emission Tomography/Computed Tomography (PET/CT) throughout the US. Here we performed a systematic review and meta-analysis to evaluate the impact of SSTR PET/CT on the management of patients with NETs. Methods: A comprehensive literature search was performed using The National Center for Biotechnology Information PubMed online database applying the following keywords: “management” AND “PET” AND “neuroendocrine”. Fourteen of 190 studies were deemed suitable based on the following inclusion criteria: original research, cohort study, number of patients ≥ 10, reported change in management after SSTR PET/CT. Change in management across studies was determined by a random effects model. Results: A total of 1,561 patients were included. Overall, change in management occurred in 44% (range: 16-71%) of NET patients after SSTR PET/CT. In 4/14 studies SSTR PET/CT was performed after an 111In-Octreotide scan. In this subgroup additional information by SSTR PET/CT led to a change in management in 39% (range: 16-71%) of patients. Seven/14 studies differentiated between inter- and intra-modality changes with the majority of changes being inter-modality (77%, intra-modality: 23%). Conclusion: The management is changed in more than one third of patients undergoing SSTR PET/CT even when performed after an 111In-Octreotide scan. Inter-modality changes were three times more likely than intra-modality changes underlining the clinical impact of SSTR PET/CT.
- Copyright © 2017 by the Society of Nuclear Medicine and Molecular Imaging, Inc.