Article Figures & Data
Figures
- FIGURE 1.
Scatterplot with locally weighted scatterplot smoothing and 95% CI of SSTR TV and total lesion SSTR expression on baseline 68Ga-DOTATATE PET/CT and during subsequent treatment cycles. At left are morphologically responding lesions showing partial or complete response; at right are morphologically nonresponding lesions showing stable or progressive disease. CR = complete response; Loess = locally weighted scatterplot smoothing; PD = progressive disease; PR = partial response; SD = stable disease; TL = total lesion.
- FIGURE 2.
Kaplan–Meier curves of progression-free survival for SSTR TV change after C1 in all patients (A) and excluding patients with pancreatic primary NET (B), minimal absorbed dose per target lesion in C1 in all patients (C) and excluding patients with pancreatic primary NET (D), and combination of SSTR TV change after C1 and minimal absorbed dose per target lesion in C1 in all patients (E) and excluding patients with pancreatic primary NET (F). minC1 absorbed dose = minimal absorbed dose per target lesion in C1.
- FIGURE 3.
Tumor-absorbed dose as function of PRRT cycle across all target lesions. Whiskers indicate fifth and 95th percentiles.
Tables
Characteristic Data Sex Male 19 (51) Female 18 (49) Mean age at diagnosis (y) 61 ± 10 Mean age at inclusion (y) 66 ± 8.1 Median time since diagnosis (y) 3.4 (IQR, 1.7–7.7) Primary tumor site Small intestinal 23 (62) Pancreatic 10 (27) Colorectal 4 (11) Tumor grade 1 12 (32) 2 22 (59) 3 3 (8) Site of metastasis Liver 32 (86) Lymph nodes 31 (84) Bone 22 (59) Peritoneum 12 (32) Pancreas 3 (8) Lung 2 (5) Other* 6 (16) Metastatic sites involved Median number 3 (range, 1–5) ≤3 25 (68) >3 12 (32) Symptoms Diarrhea 16 (43) Pain 15 (41) Fatigue 11 (30) Flushing 9 (24) No symptoms 12 (32) 18F-FDG PET/CT–positive at baseline 15 (41) Previous treatment lines 37 (100) Previous treatments Surgery (including primary tumor resection) 27 (73) Somatostatin analogs 36 (97) Targeted therapy† 11 (30) Chemotherapy 8 (22) Liver-targeted therapy‡ 8 (22) Radiotherapy (external-beam radiation) 4 (11) Interferon 1 (3) Median number of previous treatment lines (all) 2 (range, 1–10) Previous systemic treatment lines (excluding somatostatin analogs) 16 (43) 1 10 (27) 2 5 (13) 6 1 (3) - TABLE 2.
Association Between Baseline 68Ga-DOTATATE PET/CT Parameters and Morphologic Lesion Outcome
Parameter Response Lesions (n) Median IQR P* Spearman ρ P† SUVmax R 21 18.7 14.7 to 24.2 0.71 NR 59 18.6 14.8 to 25.4 SUVmean R 21 11.4 9.7 to 13.1 0.99 NR 59 11.0 9.1 to 13.7 Tumor-to-spleen ratio R 16 1.3 0.8 to 1.9 0.03 0.04 (95% CI, −0.20 to 0.27) 0.73 NR 54 1.8 1.3 to 2.7 Tumor-to-blood ratio R 21 59.8 51.1 to 82.1 0.37 NR 59 54.6 39.6 to 80.8 SSTR TV R 21 8.4 2.4 to 26.5 0.81 NR 59 7.6 3.9 to 20.9 Total lesion SSTR expression R 21 86 45 to 227 0.81 NR 59 108 39 to 247 - TABLE 3.
Association Between Relative Change in 68Ga-DOTATATE PET/CT Parameters After C1 from Baseline and Morphologic Lesion Outcome
Parameter Response Lesions (n) Median IQR P* Spearman ρ P† SUVmax R 19 −23% −33% to 0% 0.48 NR 59 −16% −33% to 0% SUVmean R 19 −21% −39% to 3% 0.29 NR 59 −15% −29% to 5% Tumor-to-spleen ratio R 14 −32% −41% to −8% 0.91 NR 54 −30% −50% to −12% Tumor-to-blood ratio R 19 −18% −35% to 3% 0.44 NR 59 −16% −31% to 19% SSTR TV R 19 −9% −36% to 20% 0.05 0.27 (95% CI, 0.05 to 0.47) 0.01 NR 59 11% −8% to 27% Total lesion SSTR expression R 19 −27% −46% to −3% 0.01 0.32 (95% CI, 0.11 to 0.51) 0.004 NR 59 −6% −24% to 11% - TABLE 4.
Correlation Between Tumor-Absorbed C1 Dose and Lesion Morphologic Outcome in All Lesions and in Size-Based Subgroups According to Primary NET Origin
Origin Lesions (n) Spearman ρ P All lesions 61 −0.24 (−0.47 to 0.18) 0.06 Pancreatic 20 −0.35 (−0.69 to 0.11) 0.12 Small-intestinal 31 0.11 (−0.26 to 0.46) 0.53 Colorectal 10 −0.89 (−0.97 to −0.60) <0.001 Lesions < 22 mm 27 −0.07 (−0.45 to 0.33) 0.72 Pancreatic 10 −0.58 (−0.89 to 0.08) 0.06 Small-intestinal 15 0.27 (−0.29 to 0.69) 0.32 Colorectal 2* — — Lesions ≥ 22 mm 34 −0.41 (−0.67 to −0.08) 0.01 Pancreatic 10 −0.13 (−0.70 to 0.54) 0.71 Small-intestinal 16 −0.08 (−0.57 to 0.44) 0.75 Colorectal 8 −0.92 (−0.99 to −0.61) <0.001 ↵* Insufficient for analysis.
Data in parentheses are 95% CIs. Size groups are based on longest axial diameter on baseline MRI or CT.
Supplemental Data
Files in this Data Supplement:
In this issue
Jump to section
Related Articles
Cited By...
- Multicycle Dosimetric Behavior and Dose-Effect Relationships in [177Lu]Lu-DOTATATE Peptide Receptor Radionuclide Therapy
- Patient-Specific Dosimetry-Driven PRRT: Time to Move Forward!
- Dosimetry of [177Lu]Lu-DOTATATE in Patients with Advanced Midgut Neuroendocrine Tumors: Results from a Substudy of the Phase III NETTER-1 Trial
- Dosimetry Software for Theranostic Applications: Current Capabilities and Future Prospects
- The Translation of Dosimetry into Clinical Practice: What It Takes to Make Dosimetry a Mandatory Part of Clinical Practice
- Quantitative SPECT/CT Metrics in Early Prediction of [177Lu]Lu-DOTATATE Treatment Response in Gastroenteropancreatic Neuroendocrine Tumor Patients
- Absorbed Dose-Response Relationship in Patients with Gastroenteropancreatic Neuroendocrine Tumors Treated with [177Lu]Lu-DOTATATE: One Step Closer to Personalized Medicine