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Research ArticleClinical Investigation

18F-DOPA PET/CT at the Forefront of Initial or Presurgical Evaluation of Small-Intestine Neuroendocrine Tumors

Eric Ouvrard, Louis De Mestier, Caroline Boursier, Boumediene Lachachi, Nicolas Sahakian, Elodie Chevalier, Nidaa Mikail, Josefina Carullo, Aurélie Bando-Delaunay, Thomas Walter, Gabriel G. Malouf, Pietro Addeo, Gilles Poncet, Frederic Sebag, Rachida Lebtahi, Bernard Goichot, David Taïeb and Alessio Imperiale
Journal of Nuclear Medicine December 2022, 63 (12) 1865-1870; DOI: https://doi.org/10.2967/jnumed.122.263984
Eric Ouvrard
1Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France;
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Louis De Mestier
2Department of Pancreatology and Digestive Oncology, ENETS Centre of Excellence, Beaujon Hospital, Université de Paris, and INSERM U1149, Centre of Research in Inflammation, Paris, France;
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Caroline Boursier
3Nuclear Medicine, University Hospital of Nancy, Nancy, France;
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Boumediene Lachachi
4Nuclear Medicine, Hospices Civils de Lyon, Lyon, France;
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Nicolas Sahakian
5Nuclear Medicine, La Timone University Hospital, Aix-Marseille University, Marseille, France;
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Elodie Chevalier
3Nuclear Medicine, University Hospital of Nancy, Nancy, France;
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Nidaa Mikail
6Nuclear Medicine, ENETS Centre of Excellence, Beaujon Hospital, Université de Paris, Paris, France;
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Josefina Carullo
1Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France;
7Nuclear Medicine, Sanatorio Allende S.A., Cordoba, Argentina;
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Aurélie Bando-Delaunay
6Nuclear Medicine, ENETS Centre of Excellence, Beaujon Hospital, Université de Paris, Paris, France;
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Thomas Walter
8Medical Oncology, Edouard Herriot Hospital, Hospices Civils de Lyon, Université Lyon 1, Lyon, France;
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Gabriel G. Malouf
9Oncology, Institut de Cancérologie Strasbourg Europe, Strasbourg, France;
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Pietro Addeo
10Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University Hospitals of Strasbourg, Strasbourg, France;
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Gilles Poncet
11Digestive and Oncologic Surgery, Edouard-Herriot University Hospital, Claude-Bernard Lyon 1 University, Lyon, France;
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Frederic Sebag
12Endocrine Surgery, Conception University Hospital, Aix-Marseille University, Marseille, France;
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Rachida Lebtahi
6Nuclear Medicine, ENETS Centre of Excellence, Beaujon Hospital, Université de Paris, Paris, France;
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Bernard Goichot
13Diabetes and Metabolic Disorders, Internal Medicine, University Hospitals of Strasbourg, Strasbourg University, Strasbourg, France;
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David Taïeb
5Nuclear Medicine, La Timone University Hospital, Aix-Marseille University, Marseille, France;
14European Center for Research in Medical Imaging, Aix-Marseille University, Marseille, France; and
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Alessio Imperiale
1Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France;
15Molecular Imaging–DRHIM, IPHC, UMR 7178, CNRS/Unistra, Strasbourg, France
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Abstract

Our objective was to compare the respective value of 68Ga-DOTATOC and 18F-DOPA PET/CT for initial staging or presurgical work-up of patients with small-intestine neuroendocrine tumors (SiNETs). Methods: This was a retrospective, multicenter, noninterventional investigation involving 53 non–surgically treated SiNET patients who underwent both 68Ga-DOTATOC and 18F-DOPA PET/CT within a 6-mo interval without surgical intervention or therapeutic change between the 2 PET/CT studies. Percentage detection rate was calculated according to per-region and per-lesion analyses. Sensitivity for primary tumor detection was assessed in 37 surgically treated patients, taking surgical results (76 SiNETs) as the diagnostic gold standard. Results: 68Ga-DOTATOC PET/CT and 18F-DOPA PET/CT individually identified at least 1 primary SiNET in 92% (34/37) of the patients. Intestinal tumor multifocality was confirmed by histology in 8 patients. 68Ga-DOTATOC and 18F-DOPA PET/CT were concordantly positive for tumor multifocality in 5 patients, discordantly positive in 2 patients, and concordantly negative in 1 patient. The detection rate for subdiaphragmatic nodal metastases on per-region–based analysis was 91% and 98% for 68Ga-DOTATOC and 18F-DOPA PET/CT, respectively (P = 0.18). 18F-DOPA PET/CT detected a higher number of abnormal subdiaphragmatic nodes (P = 0.009). Regarding mesenteric nodes only, 18F-DOPA PET/CT detected more positive regions (P = 0.005) and nodal lesions (P = 0.003) than 68Ga-DOTATOC PET/CT, including nodes at the origin of mesenteric vessels. For detection of distant metastases, 68Ga-DOTATOC and 18F-DOPA PET/CT performed equally well on a per-region–based analysis. As compared with 68Ga-DOTATOC, 18F-DOPA PET/CT detected more hepatic (P < 0.001), peritoneal (P < 0.001), and lung metastases (P < 0.001). Conclusion: 18F-DOPA PET/CT detected more lesions than 68Ga-DOTATOC PET/CT in the studied patients. The respective roles of the two should be discussed in terms of disease staging and treatment selection.

  • 68Ga-DOTATOC
  • 18F-DOPA
  • PET
  • neuroendocrine
  • small intestine
  • carcinoid
  • staging

Footnotes

  • Published online May. 19, 2022.

  • © 2022 by the Society of Nuclear Medicine and Molecular Imaging.
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Journal of Nuclear Medicine: 63 (12)
Journal of Nuclear Medicine
Vol. 63, Issue 12
December 1, 2022
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18F-DOPA PET/CT at the Forefront of Initial or Presurgical Evaluation of Small-Intestine Neuroendocrine Tumors
Eric Ouvrard, Louis De Mestier, Caroline Boursier, Boumediene Lachachi, Nicolas Sahakian, Elodie Chevalier, Nidaa Mikail, Josefina Carullo, Aurélie Bando-Delaunay, Thomas Walter, Gabriel G. Malouf, Pietro Addeo, Gilles Poncet, Frederic Sebag, Rachida Lebtahi, Bernard Goichot, David Taïeb, Alessio Imperiale
Journal of Nuclear Medicine Dec 2022, 63 (12) 1865-1870; DOI: 10.2967/jnumed.122.263984

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18F-DOPA PET/CT at the Forefront of Initial or Presurgical Evaluation of Small-Intestine Neuroendocrine Tumors
Eric Ouvrard, Louis De Mestier, Caroline Boursier, Boumediene Lachachi, Nicolas Sahakian, Elodie Chevalier, Nidaa Mikail, Josefina Carullo, Aurélie Bando-Delaunay, Thomas Walter, Gabriel G. Malouf, Pietro Addeo, Gilles Poncet, Frederic Sebag, Rachida Lebtahi, Bernard Goichot, David Taïeb, Alessio Imperiale
Journal of Nuclear Medicine Dec 2022, 63 (12) 1865-1870; DOI: 10.2967/jnumed.122.263984
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Keywords

  • 68Ga-DOTATOC
  • 18F-DOPA
  • PET
  • Neuroendocrine
  • small intestine
  • carcinoid
  • Staging
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