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Impact of 68Ga-DOTATATE PET/CT on the Surgical Management of Primary Neuroendocrine Tumors of the Pancreas or Ileum

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Resection is the only curative treatment in patients suffering from neuroendocrine tumors (NETs) of the ileum or the pancreas. Accurate preoperative imaging is critical for surgical planning, as even findings of small and distant metastases may profoundly influence surgical management.

Methods

68Ga-DOTATATE PET/CT was performed preoperatively in 44 patients suffering from NET of the ileum (n = 26) or the pancreas (n = 18) before surgery at our University Hospital. Data were analyzed retrospectively by an interdisciplinary team of nuclear medicine and visceral surgery specialists. Intended surgical management was documented before and after availability of PET/CT findings. The team judged whether the imaging findings provided additional information relevant to surgical planning.

Results

Imaging results altered surgical management in 9 of 44 (20 %) patients, more specifically in 3 of 26 (12 %) patients with NET of the ileum and in 6 of 18 (33 %) patients with NET of the pancreas. PET/CT findings led to a more invasive surgical approach in 6 cases (3 each of ileum and pancreas) and to a less invasive strategy in 3 patients with NET of the pancreas. Although PET/CT results did not alter management in 35 of 44 patients, somatostatin receptor imaging still provided additional information for surgery planning in more than 95 % of the cases.

Conclusions

Additional information provided by 68Ga-DOTATATE PET/CT in the preoperative workup significantly influences surgical management in one-fifth of our NET patients and, notably, one-third of those suffering from NET of the pancreas.

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Acknowledgment

The authors acknowledge expert textual revisions provided by Paul Cumming.

Disclosure

The study was not supported by any funding sources. The authors disclosed no potential conflict of interest.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany

    Harun Ilhan MD, Wolfgang P. Fendler MD, Franz-Josef Gildehaus PhD, Peter Bartenstein MD & Alexander R. Haug MD

  2. Department of Clinical Radiology, Ludwig-Maximilians-University of Munich, Munich, Germany

    Clemens C. Cyran MD

  3. Department of Internal Medicine II, Ludwig-Maximilians-University of Munich, Munich, Germany

    Christine Spitzweg MD & Christoph J. Auernhammer MD

  4. ENETS Centre of Excellence, Ludwig-Maximilians-University of Munich, Munich, Germany

    Christine Spitzweg MD, Christoph J. Auernhammer MD, Peter Bartenstein MD & Martin K. Angele MD

  5. Department of Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany

    Martin K. Angele MD

  6. Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria

    Alexander R. Haug MD

  7. Klinische Abteilung für Nuklearmedizin, Allgemeines Krankenhaus Wien, Vienna, Austria

    Alexander R. Haug MD

Authors
  1. Harun Ilhan MD
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  2. Wolfgang P. Fendler MD
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  3. Clemens C. Cyran MD
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  4. Christine Spitzweg MD
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  5. Christoph J. Auernhammer MD
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  6. Franz-Josef Gildehaus PhD
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  7. Peter Bartenstein MD
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  8. Martin K. Angele MD
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  9. Alexander R. Haug MD
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Corresponding author

Correspondence to Alexander R. Haug MD.

Additional information

Harun Ilhan and Wolfgang P. Fendler contributed equally to the study.

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Ilhan, H., Fendler, W.P., Cyran, C.C. et al. Impact of 68Ga-DOTATATE PET/CT on the Surgical Management of Primary Neuroendocrine Tumors of the Pancreas or Ileum. Ann Surg Oncol 22, 164–171 (2015). https://doi.org/10.1245/s10434-014-3981-2

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  • DOI: https://doi.org/10.1245/s10434-014-3981-2

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