The impact of 68Ga-DOTATATE PET/CT on the management of neuroendocrine tumors: The referring physician's perspective

Objectives PET/CT using 68Ga-DOTATATE is a molecular body imaging modality that is increasingly being used for diagnosing, staging, and restaging of neuroendocrine tumors. The objective of this study was to determine referring physicians' perspectives on the impact of 68Ga-DOTATATE PET/CT on staging and management of neuroendocrine tumors.

Methods A questionnaire was sent to the referring physicians of 18 consecutive patients with known or suspected neuroendocrine tumors who were evaluated with 68Ga-DOTATATE PET/CT. Questionnaires on 16 patients were returned (response rate, 89%). Management changes were categorized as intermodality (e.g., surgery to medical, surgery to radiation, or medical to no treatment) or intramodality (e.g., altered medical, surgical, or radiotherapy approach). The number of additional tests that could be avoided because of the results from the 68Ga-DOTATATE PET/CT was tabulated.

Results The primary reasons for PET/CT referral were staging of neuroendocrine tumors in 50% of patients, and re-staging in 50%. Physicians reported that PET/CT led to a change in clinical stage in 31% of all patients. The disease was upstaged in 31% and down staged in 0%. PET/CT resulted in intermodality management changes in 19% of patients, whereas 19% had an intramodality change. In 56% of patients additional tests could be avoided because of the information provided by the 68Ga-DOTATATE PET/CT.

Conclusions These initial data from an ongoing survey of referring physicians suggest that 68Ga-DOTATATE PET/CT has a major impact on staging and management of neuroendocrine neoplasms.