PT  - JOURNAL ARTICLE
AU  - Menda, Yusuf
AU  - O'Dorisio, Thomas
AU  - Graham, Michael
AU  - Howe, James
AU  - Dick, David
AU  - Dillon, Joseph
AU  - Schultz, Michael
AU  - Watkins, Gordon
AU  - Sunderland, John
AU  - O'Dorisio, M Sue
TI  - Role of Gallium-68 DOTATOC PET-CT in Neuroendocrine Tumors with Unknown Primary Site
DP  - 2015 May 01
TA  - Journal of Nuclear Medicine
PG  - 143--143
VI  - 56
IP  - supplement 3
4099  - http://jnm.snmjournals.org/content/56/supplement_3/143.short
4100  - http://jnm.snmjournals.org/content/56/supplement_3/143.full
SO  - J Nucl Med2015 May 01; 56
AB  - 143 Objectives Previous studies suggest a survival advantage in patients (pts) with metastatic neuroendocrine tumor (NET), who undergo resection of the primary tumor. The goal of this study is to evaluate Ga-68 DOTATOC PET-CT in localization of the primary NET in pts presenting with metastases and unknown primary site.Methods A single center prospective study was performed to evaluate the safety and efficacy of Ga-68 DOTATOC PET-CT in pts with proven or suspected NET. Ga-68 DOTATOC was produced under a physician-sponsored investigational new drug (IND) approval using an automated 68Ge/68Ga generator coupled with a ModularLab PharmTracer fluid handling system (Eckert-Ziegler). PET-CT scans were obtained approximately 60 min after the IV administration of 148 MBq of Ga-68 DOTATOC with a low-dose non-contrast CT. Images were interpreted qualitatively with focal uptake above normal background considered positive for NET.Results 36 pts with metastatic NET and unknown primary tumor site were evaluated with Ga-68 DOTATOC PET-CT. No primary tumor was identified in 7 pts, who did not have DOTATOC avid metastases. In 29 pts with DOTATOC avid metastases, Ga-68 DOTATOC PET-CT suggested a primary tumor site in 19 pts. The primary site indicated by Ga-68 DOTATOC PET-CT was confirmed in 11 pts, by histology in 8 and by imaging in 3 pts. There were 3 false positives, either nontumoral or lymphadenopathy suggesting primary tumor. 5 lesions identified on Ga-68 DOTATOC PET-CT scans remain unconfirmed. 7 pts underwent resection of primary tumor and 1 pt underwent peptide receptor radionuclide therapy, resulting in a major change in management in 28% of pts, who have DOTATOC avid metastases and unknown primary tumor site.Conclusions Ga-68 DOTATOC PET-CT can identify the primary tumor, which leads to a significant change in management in pts with metastatic NET and unknown primary tumor site.