Article Figures & Data
Figures
- FIGURE 1.
(A) Congruent imaging: [68Ga]Ga-DOTATATE imaging and [18F]FET-βAG-TOCA imaging (maximum-intensity projection [MIP], axial PET, fused and CT images) in metastatic small-bowel NEN with widespread liver and bone metastases. (B) Incongruent imaging: [68Ga]Ga-DOTATATE imaging and [18F]FET-βAG-TOCA imaging (MIP, axial PET, fused and CT images) performed 4 wk apart in metastatic ileal NEN with liver metastases (green arrows), which are more visible on [18F]FET-βAG-TOCA. Additional lesion is detected on [18F]FET-βAG-TOCA (blue arrow).
- FIGURE 2.
Bland–Altman plot of difference in SUVmax between [18F]FET-βAG-TOCA and [68Ga]Ga-DOTA-peptide.
Tables
Variable Value* Age (y) Median 57 Range 29–81 Sex Male 23 (51) Female 22 (49) Stage Locally advanced 4 (9) Metastatic 41 (91) Site of primary tumor Pancreas 15 (33) Small bowel 20 (44) Lung 3 (7) Other 7 (16) Grade 1 15 (33) 2 21 (47) Unknown 9 (20) Site of metastatic disease Liver 27 (60) Bone 12 (27) Nodes 10 (22) Lung 3 (7) Other 17 (38) Median Ki-67 (%) 3 (7)† Chromogranin A (ng/mL) 72 (92)† Previous treatment Surgery 24 (53) Somatostatin analogs 20 (44) Chemotherapy 9 (20) PRRT 7 (16) RFA 6 (13) Other 3 (7) - TABLE 2.
Discordant Lesions Between [18F]FET-βAG-TOCA (FETO) and [68Ga]Ga-DOTA-peptide (DOTA) PET/CT
Patient Time between scans (mo) Congruent site(s) Lesion Discordant lesion site Lesion size (mm) Scan 1 4.6 Liver 1 Liver 7 FETO 2 0.2 Liver, nodal 2 Node 5 FETO 3 Node 5 FETO 3 4.8 Liver, peritoneal 4 Liver 7 FETO 4 0.6 Bone 5 Bone 3 FETO 5 4.3 Liver, nodal 6 Liver 10 DOTA 6 2.5 Gastric, liver 7 Liver 8 DOTA 8 Liver 8 DOTA 7 0.2 Liver, nodal 9 Liver 12 DOTA 10 Pancreas 13 DOTA 8 1.6 Bone, nodal 11 Bone 10 FETO 12 Bone 4 FETO 13 Bone 4 FETO 14 Small bowel 5 FETO 15 Node 15 DOTA 9 1.1 Liver 16 Liver 9 FETO 17 Liver 9 FETO 10 3.7 Liver, nodal 18 Liver 5 FETO 11 4.4 Liver, bone 19 Bone 3 DOTA 20 Liver 8 FETO - TABLE 3.
Median Tumor Uptake (SUVmax) and Tumor-to-Background Ratio (TBR) of [18F]FET-βAG-TOCA and [68Ga]Ga-DOTA-peptide per Anatomic Region
[18F]FET-βAG-TOCA [68Ga]Ga-DOTA-peptide Median TBR with: Region No. of lesions Median SUVmax Range Median SUVmax Range P [18F]FET- βAG-TOCA [68Ga]Ga- DOTA-peptide P Head and neck 3 12.4 10.4–27.7 6.9 6.4–23.4 0.5 29.8 12.2 0.3 Liver 110 19.59 7.2–132.4 20.6 6.7–95.1 0.5 2.5 3.5 <0.001 Bone 49 9.7 2.2–37.0 7.2 1.9–38.8 0.5 12.5 10.1 0.5 Lung 11 10.4 5.3–42.1 9.4 2.2–38.0 0.9 14.6 15.4 0.4 Pancreas 28 24.5 4.2–85.8 21.9 6.4–88.4 0.8 35.2 36.6 0.6 Abdomen/pelvis 36 18.8 2.7–152.3 21.2 4.1–110.3 0.6 23.5 23.6 0.1 Lymph nodes 48 18.0 3.4–102.4 17.0 3.1–122.9 0.7 21.1 29.7 0.5 - TABLE 4.
Interrater Agreement for [18F]FET-βAG-TOCA and [68Ga]Ga-DOTA-peptide per Anatomic Region Between All 4 Raters
Agreement between raters 1, 2, 3, and 4 for: [18F]FET-βAG-TOCA [68Ga]Ga-DOTA-peptide Scan site Agreement (%) κ* P Agreement (%) κ* P P for [18F]FET- βAG-TOCA vs. [68Ga]Ga- DOTA-peptide Head and neck 97.4 0.2 (−0.01 to 0.3) <0.001 97.8 −0.01 (−0.02 to −0.006) 0.6 0.04 Lung 97.8 −0.01 (−0.02 to −0.01) 0.6 98.9 −0.01 (NC) 0.5 NC Liver 94.4 −0.03 (−0.05 to −0.006) 0.7 98.5 0.3 (NC) <0.001 <0.001 Pancreas 89.3 0.2 (0.1 to 0.3) <0.001 91.5 0.1 (−0.03 to 0.3) 0.05 0.2 Abdomen/pelvis 88.5 0.0005 (−0.07 to 0.2) 0.5 95.2 0.1 (−0.02 to 0.3) 0.04 0.3 Bone 98.5 0.3 (NC) <0.001 100.0 NC NC NC Lymph nodes 97.4 0.3 (−0.01 to 0.3) <0.001 96.3 0.2 (−0.02 to 0.3) 0.008 0.7 ↵* Values in parentheses are 95% CIs.
NC = noncalculable.
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