Abstract
2093
Objectives The objective of the present study was to evaluate the role of 68Ga-labelled [1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid]-1-NaI3-Octreotide (Ga68-DOTANOC) positron emission tomography computed tomography (PET-CT) for detection and staging of pancreatic neuroendocrine tumors (NETs).
Methods 37 patients (Age: 47±13.3 years; male/female: 20/17) with clinically suspected and/or histopathologically proven pancreatic NET underwent Ga68-DOTANOC PET-CT imaging for staging (n=8) and /or localisation of primary lesion (n=29). All patients also underwent contrast enhanced CT (CECT). SUVmax of primary and metastatic lesions were measured. Results were verified with histopathology for primary tumor and with clinical follow up/MRI and /or biopsy for metastatic disease. Results of Ga68-DOTANOC PET-CT were compared to CECT.
Results Ga68-DOTANOC PET-CT correctly localised primary in all 37 and CECT in 28 patients. Ga68-DOTANOC PET-CT demonstrated 39 primary pancreatic tumors (head-16, body-17, and tail-6). The mean SUVmax of primary tumors was 21.5±22.7. The accuracy of Ga68-DOTANOC PET-CT detecting primary tumor was 100% and that of CECT was 70.2%.Ga68-DOTANOC PET-CT demonstrated metastases in 25 patients and CECT in 15. Liver and lymph nodes were commonest site of metastases on PET-CT. The mean SUVmax of metastasis was 17.6±11.6. The sensitivity, specificity and accuracy for detection metastatic disease were 96%, 100%, 97% for Ga68-DOTANOC PET-CT and 58%, 100%, and 70% for CECT. On McNemar analysis Ga68-DOTANOC PET-CT was superior to CECT for detecting both primary tumor (p=0.003) and metastatic disease (p=0.006).
Conclusions Ga68-DOTANOC PET-CT is a very useful imaging modality for diagnosing and staging pancreatic NET. It is superior to CECT for this purpose