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Role of 68Ga-DOTATOC PET/CT in initial evaluation of patients with suspected bronchopulmonary carcinoid

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The objective of this study was to evaluate the role of 68Ga-DOTATOC positron emission tomography (PET)/CT scan in patients with suspected pulmonary carcinoid tumour and to compare its results with 18F-fluorodeoxyglucose (FDG) PET/CT scan.

Methods

In this prospective study, 32 patients (age 34.22 ± 12.03 years; 53.1 % female) with clinical suspicion of bronchopulmonary carcinoid were evaluated with 68Ga-DOTATOC PET/CT and 18F-FDG PET/CT. The two imaging modalities were compared, considering the tissue diagnosis as the reference standard.

Results

Based on the reference standard 26 cases were carcinoid tumours [21 typical carcinoids (TC) and 5 atypical carcinoids (AC)] and 6 cases were non-carcinoid tumours. The sensitivity, specificity and accuracy of 68Ga-DOTATOC PET/CT in the diagnosis of pulmonary carcinoid tumour were 96.15, 100 and 96.87 % respectively, whereas those of 18F-FDG PET/CT were 78.26, 11.1 and 59.37 % respectively. The maximum standardised uptake value (SUVmax) of TC on 68Ga-DOTATOC PET/CT scan ranged from 3.58 to 55, while that of AC ranged from 1.1 to 32.5. 18F-FDG PET/CT was true-positive in all cases of AC and false-negative in eight cases of TC (sensitivity for TC 61.9 % and for AC 100 %).

Conclusion

68Ga-DOTATOC PET/CT is a useful imaging investigation for the evaluation of pulmonary carcinoids. 18F-FDG PET/CT scan suffers from low sensitivity and specificity in differentiating the pulmonary carcinoids from other tumours.

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References

  1. Klöppel G. Tumour biology and histopathology of neuroendocrine tumours. Best Pract Res Clin Endocrinol Metab 2007;21:15–31.

    Article  PubMed  Google Scholar 

  2. Beasley MB, Brambilla E, Travis WD. The 2004 World Health Organization classification of lung tumors. Semin Roentgenol 2005;40:90–7.

    Article  PubMed  Google Scholar 

  3. Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer 2003;97:934–59.

    Article  PubMed  Google Scholar 

  4. Hauso O, Gustafsson BI, Kidd M, Waldum HL, Drozdov I, Chan AK, et al. Neuroendocrine tumor epidemiology: contrasting Norway and North America. Cancer 2008;113:2655–64.

    Article  PubMed  Google Scholar 

  5. Cooper WA, Thourani VH, Gal AA, Lee RB, Mansour KA, Miller JI. The surgical spectrum of pulmonary neuroendocrine neoplasms. Chest 2001;119:14–8.

    Article  CAS  PubMed  Google Scholar 

  6. Fink G, Krelbaum T, Yellin A, Bendayan D, Saute M, Glazer M, et al. Pulmonary carcinoid: presentation, diagnosis, and outcome in 142 cases in Israel and review of 640 cases from the literature. Chest 2001;119:1647–51.

    Article  CAS  PubMed  Google Scholar 

  7. Filosso PL, Rena O, Donati G, Casadio C, Ruffini E, Papalia E, et al. Bronchial carcinoid tumors: surgical management and long-term outcome. J Thorac Cardiovasc Surg 2002;123:303–9.

    Article  PubMed  Google Scholar 

  8. Jeung MY, Gasser B, Gangi A, Charneau D, Ducroq X, Kessler R, et al. Bronchial carcinoid tumors of the thorax: spectrum of radiologic findings. Radiographics 2002;22:351–65.

    Article  PubMed  Google Scholar 

  9. Ambrosini V, Tomassetti P, Castellucci P, Campana D, Montini G, Rubello D, et al. Comparison between 68Ga-DOTA-NOC and 18F-DOPA PET for the detection of gastro-entero-pancreatic and lung neuro-endocrine tumours. Eur J Nucl Med Mol Imaging 2008;35:1431–8.

    Article  CAS  PubMed  Google Scholar 

  10. Ambrosini V, Castellucci P, Rubello D, Nanni C, Musto A, Allegri V, et al. 68Ga-DOTA-NOC: a new PET tracer for evaluating patients with bronchial carcinoid. Nucl Med Commun 2009;30:281–6.

    Article  PubMed  Google Scholar 

  11. Kumar R, Sharma P, Garg P, Karunanithi S, Naswa N, Sharma R, et al. Role of (68)Ga-DOTATOC PET-CT in the diagnosis and staging of pancreatic neuroendocrine tumors. Eur Radiol 2011;21:2408–16.

    Article  PubMed  Google Scholar 

  12. El Jamal M, Nicholson AG, Goldstraw P. The feasibility of conservative resection for carcinoid tumours: is pneumonectomy ever necessary for uncomplicated cases? Eur J Cardiothorac Surg 2000;18:301–6.

    Article  PubMed  Google Scholar 

  13. McCaughan BC, Martini N, Bains MS. Bronchial carcinoids. Review of 124 cases. J Thorac Cardiovasc Surg 1985;89:8–17.

    CAS  PubMed  Google Scholar 

  14. Beasley MB, Thunnissen FB, Brambilla E, Hasleton P, Steele R, Hammar SP, et al. Pulmonary atypical carcinoid: predictors of survival in 106 cases. Hum Pathol 2000;31:1255–65.

    Article  CAS  PubMed  Google Scholar 

  15. Rosado de Christenson ML, Abbott GF, Kirejczyk WM, Galvin JR, Travis WD. Thoracic carcinoids: radiologic-pathologic correlation. Radiographics 1999;19:707–36.

    Article  CAS  PubMed  Google Scholar 

  16. Pelosi G, Rodriguez J, Viale G, Rosai J. Typical and atypical pulmonary carcinoid tumor overdiagnosed as small-cell carcinoma on biopsy specimens: a major pitfall in the management of lung cancer patients. Am J Surg Pathol 2005;29:179–87.

    Article  PubMed  Google Scholar 

  17. Hofmann M, Maecke H, Börner R, Weckesser E, Schöffski P, Oei L, et al. Biokinetics and imaging with the somatostatin receptor PET radioligand (68)Ga-DOTATOC: preliminary data. Eur J Nucl Med 2001;28:1751–7.

    Article  CAS  PubMed  Google Scholar 

  18. Kowalski J, Henze M, Schuhmacher J, Mäcke HR, Hofmann M, Haberkorn U. Evaluation of positron emission tomography imaging using [68Ga]-DOTA-D Phe(1)-Tyr(3)-Octreotide in comparison to [111In]-DTPAOC SPECT. First results in patients with neuroendocrine tumors. Mol Imaging Biol 2003;5:42–8.

    Article  PubMed  Google Scholar 

  19. Koukouraki S, Strauss LG, Georgoulias V, Eisenhut M, Haberkorn U, Dimitrakopoulou-Strauss A. Comparison of the pharmacokinetics of 68Ga-DOTATOC and [18F]FDG in patients with metastatic neuroendocrine tumours scheduled for 90Y-DOTATOC therapy. Eur J Nucl Med Mol Imaging 2006;33:1115–22.

    Article  CAS  PubMed  Google Scholar 

  20. Gabriel M, Decristoforo C, Kendler D, Dobrozemsky G, Heute D, Uprimny C, et al. 68Ga-DOTA-Tyr3-octreotide PET in neuroendocrine tumors: comparison with somatostatin receptor scintigraphy and CT. J Nucl Med 2007;48:508–18.

    Article  CAS  PubMed  Google Scholar 

  21. Kayani I, Bomanji JB, Groves A, Conway G, Gacinovic S, Win T, et al. Functional imaging of neuroendocrine tumors with combined PET/CT using 68Ga-DOTATATE (DOTA-DPhe1, Tyr3-octreotate) and 18F-FDG. Cancer 2008;112:2447–55.

    Article  PubMed  Google Scholar 

  22. Miederer M, Seidl S, Buck A, Scheidhauer K, Wester HJ, Schwaiger M, et al. Correlation of immunohistopathological expression of somatostatin receptor 2 with standardised uptake values in 68Ga-DOTATOC PET/CT. Eur J Nucl Med Mol Imaging 2009;36:48–52.

    Article  CAS  PubMed  Google Scholar 

  23. Treglia G, Castaldi P, Rindi G, Giordano A, Rufini V. Diagnostic performance of gallium-68 somatostatin receptor PET and PET/CT in patients with thoracic and gastroenteropancreatic neuroendocrine tumours: a meta-analysis. Endocrine 2012;42:80–7.

    Article  CAS  PubMed  Google Scholar 

  24. Daniels CE, Lowe VJ, Aubry M-C, Allen MS, Jett JR. The utility of fluorodeoxyglucose positron emission tomography in the evaluation of carcinoid tumors presenting as pulmonary nodules. Chest 2007;131:255–60.

    Article  PubMed  Google Scholar 

  25. Erasmus JJ, McAdams HP, Patz Jr EF, Coleman RE, Ahuja V, Goodman PC. Evaluation of primary pulmonary carcinoid tumors using FDG PET. AJR Am J Roentgenol 1998;170:1369–73.

    Article  CAS  PubMed  Google Scholar 

  26. Marom EM, Sarvis S, Herndon 2nd JE, Patz Jr EF. T1 lung cancers: sensitivity of diagnosis with fluorodeoxyglucose PET. Radiology 2002;223:453–9.

    Article  PubMed  Google Scholar 

  27. Wartski M, Alberini JL, Leroy-Ladurie F, De Montpreville V, Nguyen C, Corone C, et al. Typical and atypical bronchopulmonary carcinoid tumors on FDG PET/CT imaging. Clin Nucl Med 2004;29:752–3.

    Article  PubMed  Google Scholar 

  28. Chong S, Lee KS, Kim BT, Choi JY, Yi CA, Chung MJ, et al. Integrated PET/CT of pulmonary neuroendocrine tumors: diagnostic and prognostic implications. AJR Am J Roentgenol 2007;188:1223–31.

    Article  PubMed  Google Scholar 

  29. Haug A, Auernhammer CJ, Wängler B, Tiling R, Schmidt G, Göke B, et al. Intraindividual comparison of 68Ga-DOTA-TATE and 18F-DOPA PET in patients with well-differentiated metastatic neuroendocrine tumours. Eur J Nucl Med Mol Imaging 2009;36:765–70.

    Article  CAS  PubMed  Google Scholar 

  30. Jindal T, Kumar A, Venkitaraman B, Meena M, Kumar R, Malhotra A, et al. Evaluation of the role of [18F]FDG-PET/CT and [68Ga]DOTATOC-PET/CT in differentiating typical and atypical pulmonary carcinoids. Cancer Imaging 2011;11:70–5.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Lee EY, Vargas SO, Sawicki GS, Boyer D, Grant FD, Voss SD. Mucoepidermoid carcinoma of bronchus in a pediatric patient: (18)F-FDG PET findings. Pediatr Radiol 2007;37:1278–82.

    Article  PubMed  Google Scholar 

  32. Ishizumi T, Tateishi U, Watanabe S-I, Maeda T, Arai Y. F-18 FDG PET/CT imaging of low-grade mucoepidermoid carcinoma of the bronchus. Ann Nucl Med 2007;21:299–302.

    Article  PubMed  Google Scholar 

  33. Nakamura R, Ishikawa S, Sakai M, Goto Y, Minami Y. Increased fluorodeoxyglucose-uptake in positron emission tomography with an endobronchial schwannoma occluding the left main stem bronchus. J Thorac Oncol 2009;4:1183–4.

    Article  PubMed  Google Scholar 

  34. Park CM, Goo JM, Lee HJ, Kim MA, Lee CH, Kang MJ. Tumors in the tracheobronchial tree: CT and FDG PET features. Radiographics 2009;29:55–71.

    Article  PubMed  Google Scholar 

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Funding

No financial assistance/grant was received for this study.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Surgery, All India Institute of Medical Sciences, New Delhi, India

    Balasubramanian Venkitaraman & Arvind Kumar

  2. Department of Nuclear Medicine, All India Institute of Medical Sciences, E-81, Ansari Nagar (East), AIIMS Campus, New Delhi, 110029, India

    Sellam Karunanithi & Rakesh Kumar

  3. Department of Pulmonary Medicine, All India Institute of Medical Sciences, New Delhi, India

    G. C. Khilnani

Authors
  1. Balasubramanian Venkitaraman
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  2. Sellam Karunanithi
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  4. G. C. Khilnani
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  5. Rakesh Kumar
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Correspondence to Rakesh Kumar.

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Venkitaraman, B., Karunanithi, S., Kumar, A. et al. Role of 68Ga-DOTATOC PET/CT in initial evaluation of patients with suspected bronchopulmonary carcinoid. Eur J Nucl Med Mol Imaging 41, 856–864 (2014). https://doi.org/10.1007/s00259-013-2659-5

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  • DOI: https://doi.org/10.1007/s00259-013-2659-5

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