RT Journal Article
SR Electronic
T1 A Comparison of <sup>68</sup>Ga-DOTATATE and <sup>18</sup>F-FDG PET/CT in Pulmonary Neuroendocrine Tumors
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1927
OP 1932
DO 10.2967/jnumed.109.066639
VO 50
IS 12
A1 Kayani, Irfan
A1 Conry, Brendon G.
A1 Groves, Ashley M.
A1 Win, Thida
A1 Dickson, John
A1 Caplin, Martyn
A1 Bomanji, Jamshed B.
YR 2009
UL http://jnm.snmjournals.org/content/50/12/1927.abstract
AB Our purpose was to compare the performance of 68Ga-1,4,7,10-tetraazacyclododecane-N,N′,N″,N‴-tetraacetic acid-d-Phe1,Tyr3-octreotate (DOTATATE), a novel selective somatostatin receptor 2 PET ligand, and 18F-FDG in the detection of pulmonary neuroendocrine tumors using PET/CT, with correlation of uptake and tumor grade on histology. Methods: The imaging findings of the first 18 consecutive patients (8 men and 10 women) with pulmonary neuroendocrine tumors (11 typical carcinoids, 2 atypical carcinoids, 1 large cell neuroendocrine tumor, 1 small cell neuroendocrine carcinoma, 1 non–small cell lung cancer with neuroendocrine differentiation, and 2 cases of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia) who underwent 68Ga-DOTATATE and 18F-FDG PET/CT were reviewed. In all cases, the diagnosis was established on histology. Results: Of 18 patients, 15 had primary tumors (median size, 2.7 cm; range, 0.5–8 cm) and 3 had recurrent tumors. All typical carcinoids showed high uptake of 68Ga-DOTATATE (maximum standardized uptake value [SUVmax] ≥ 8.2), but 4 of 11 showed negative or minimal 18F-FDG uptake (SUVmax = 1.7–2.9). All tumors of higher grade showed high uptake of 18F-FDG (SUVmax ≥ 11.7), but 3 of 5 showed only minimal accumulation of 68Ga-DOTATATE (SUVmax = 2.2–2.8). Neither case of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia showed uptake of 68Ga-DOTATATE or 18F-FDG. Typical carcinoids showed significantly higher uptake of 68Ga-DOTATATE and significantly less uptake of 18F-FDG than did tumors of higher grade (P = 0.002 and 0.005). There was no instance of false-positive uptake of 68Ga-DOTATATE, but there were 3 sites of 18F-FDG uptake secondary to inflammation. 68Ga-DOTATATE was superior to 18F-FDG in discriminating endobronchial tumor from distal collapsed lung (P = 0.02). Conclusion: Typical bronchial carcinoids showed higher and more selective uptake of 68Ga-DOTATATE than of 18F-FDG. Atypical carcinoids and higher grades had less 68Ga-DOTATATE avidity but were 18F-FDG–avid.