Treatment with Octreotide Does Not Reduce Tumor Uptake of 68Ga-DOTATATE as Measured by PET/CT in Patients with Neuroendocrine Tumors

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FIGURE 1.
Axial views and multiple-intensity projections of 2 PET/CT scans from same patient: scan under treatment with long-acting octreotide (A) and scan without treatment (B). Although SUV_max of metastases was not different (32.9 and 31.6 with and without treatment, respectively), uptake of both spleen (20.2 and 25.3, respectively) and liver (9.5 and 11.5, respectively) was notably lower under long-acting octreotide treatment. Between the 2 examinations, no disease progression was evident and no treatment was performed.
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FIGURE 2.
SUV_max measurements of tumor with highest value per patient. Mann–Whitney U test revealed no difference between groups with and without octreotide medication (P = 0.70).
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FIGURE 3.
SUV_max measurements of liver. Mann–Whitney U test revealed significantly lower SUV_max in group with octreotide treatment than in group without (P < 0.001).
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FIGURE 4.
SUV_max measurements of up to 5 tumors per organ and patient in subgroup of 9 patients with successive PET scans with and without octreotide medication. Wilcoxon test revealed no statistical difference (P = 0.93).

TABLE 1

Demographics and Tumor Sites for Treated and Untreated Patients

TABLE 2

SUV_max and SUV_mean of Organs, Primary Tumors, and Metastases in Treated and Untreated Patients

Parameter	Octreotide	No octreotide	P
Most intense metastases per patient
SUV_max	32.5 ± 16.6 (10.8–70.1)	33.0 ± 23.0 (6.3–117.1)	0.73
SUV_mean	11.2 ± 6.8 (3.7–25.6)	10.6 ± 5.1 (3.6–21.8)	0.83
Primary tumor
SUV_max	28.6 ± 6.8 (23.8–33.4)	32.9 ± 31.5 (6.3–117.1)	0.69
SUV_mean	19.8 ± 6.7 (15.1–24.5)	21.3 ± 19.5 (4.1–72.7)	0.55
Liver metastases
SUV_max	27.2 ± 14.8 (8.1–66.4)	25.7 ± 10.7 (9.8–56.8)	0.92
SUV_mean	18.5 ± 10.7 (5.2–46.3)	16.9 ± 7.5 (6.9–39.9)	0.83
Lymph node metastases
SUV_max	41.4 ± 19.5 (5.6–68.8)	25.0 ± 6.3 (18.1–33.0)	0.20
SUV_mean	27.1 ± 13.1 (3.6–45.7)	16.4 ± 4.8 (11.2–22.0)	0.17
Osseous metastases
SUV_max	39.5 ± 22.0 (11.5–70.1)	15.4 ± 7.8 (10.2–27.0)	0.49
SUV_mean	26.9 ± 15.7 (6.6–48.6)	10.2 ± 5.1 (6.7–17.8)	0.38
Lung metastases
SUV_max	None	21.4 ± 11.0 (13.7–29.2)	NA
SUV_mean	None	14.0 ± 7.1 (9.0–19.0)	NA
Liver
SUV_max	7.1 ± 2.1 (3.5–11.9)	9.3 ± 2.9 (3.7–19.2)	<0.001
SUV_mean	4.9 ± 1.4 (2.8–7.4)	6.6 ± 1.9 (2.8–12.8)	<0.001
Spleen
SUV_max	18.4 ± 6.4 (9.5–31.8)	24.9 ± 6.7 (10.4–43.8)	<0.001
SUV_mean	12.8 ± 4.4 (6.4–23.5)	18.2 ± 5.0 (7.2–32.8)	<0.001
Adrenal gland
SUV_max	18.3 ± 5.7 (9.4–28.0)	20.0 ± 5.6 (10.1–41.2)	0.70
SUV_mean	11.7 ± 3.7 (6.0–17.7)	14.9 ± 16.4 (7.2–18.5)	0.76
Pituitary gland
SUV_max	3.9 ± 4.8 (0.4–19.3)	2.0 ± 0.8 (0.5–3.5)	0.12
SUV_mean	2.6 ± 3.2 (0.3–13.0)	1.3 ± 0.5 (0.3–2.4)	0.08
Kidney
SUV_max	14.5 ± 6.0 (5.9–31.0)	15.8 ± 4.6 (8.3–35.0)	0.24
SUV_mean	9.5 ± 3.3 (4.1–17.3)	10.4 ± 2.8 (5.4–22.5)	0.32