Abstract
1005
Background: Neuroendocrine tumors (NET) arise from specialized hormone-producing endocrine cells and nerve cells. Traditionally they are graded based on mitotic index (Ki-index), however, recent understanding of this tumor suggests presence of heterogeneous histology. Identification of such heterogeneity is important to understand overall behavior of the tumor which may impact clinical decision and therapy planning. We analyzed pre-therapy 68Ga-Dotatate PET/CT scans for intra-tumoral heterogeneity of somatostatin receptors with the help of Texture Analysis (TA) software, in order to predict the overall outcome of NET.
Methods: Twenty proven cases of neuroendocrine tumor (WHO Grade I and Grade II) with pre-therapy 68Ga-Dotatate PET/CT scans were analyzed retrospectively (2017-2019). Texture analysis of the primary lesion was assessed in most patients. In patients where the primary lesion was not identified, TA was carried out on metastatic lesions. TA parameters were compared with WHO grade (Grade I and Grade II) and overall patient outcome (classified as progression versus stable disease versus regression based on review of Electronic Medical Records, radiology scans as well as tumor markers).
Results: All patients underwent treatment post 68Ga-Dotatate PET/CT scans. Within a median follow-up of 18 months, tumor progression was detected in 6/20 patients, regression was seen in 10/20 patient's and remaining 4/20 patients demonstrated stable disease. There was a significant correlation (p< 0.05) between the indices derived from TA of the patient's initial Ga Dotatate PET/CT scan and WHO grading of the tumor, and overall clinical outcome of the patients.
Conclusions: Texture analysis (based on the heterogeneity of somatostatin receptors on Ga-Dotatate scan) demonstrated significant correlation with WHO grading and clinical outcome of NET patients. This may serve as an important parameter for clinical decision making and therapy planning in this group of tumors.
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