Diagnostic performance of 68Ga-DOTANOC PET/CT in gastrinoma patients with negative or equivocal CT findings

Objectives The objective of this study was to evaluate the diagnostic performance of 68Ga-DOTANOC PET/CT in patients with a clinically suspected or established diagnosis of Gastrinoma in whom the results of conventional imaging with computed tomography (CT) were either unrevealing or equivocal.

Methods 24 patients (14male, 10 female, mean age-45.9 yrs) were included in this retrospective analysis. Inclusion criteria were a clinical symptomatology suggestive of Gastrinoma, elevated serum Gastrin levels (median value-1261.5, range 239-9516) and negative (12 patients) or equivocal CT results (12 patients).

Results 68Ga-DOTANOC PET/CT turned positive in 17/24 patients. A detection rate of 41.7% was observed in patients who had no findings on CT (5/12). Of the remaining twelve patients who had doubtful lesions on CT imaging, 68Ga-DOTANOC PET/CT was considered abnormal in all patients, yielding a detection rate of 100%. Reference standard was established using a combination of histopathology (seven patients), follow-up imaging (five patients), and biochemical markers (12 patients).Most common site of primary tumor localization was duodenum followed by pancreas (Median SUVmax-35.75). Overall 20 individual tumors were discovered in 12 patients. Previously unidentified metastatic involvement of lymph nodes were seen in nine and liver metastases in four patients (Median SUVmax-28.5).

Conclusions 68Ga-DOTANOC seems a promising imaging modality in patients suspected to have Gastrinoma with negative or indeterminate CT results. It has the potential to become a front line non-invasive imaging investigation for diagnosis and staging of such patients

• Download figure
• Open in new tab
• Download powerpoint

Patient demographics and results