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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Functional imaging in neuroendocrine tumors: assessment of molecular heterogenei...
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Vol. 43. Issue 3.
(May - June 2024)
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Vol. 43. Issue 3.
(May - June 2024)
Original Article
Functional imaging in neuroendocrine tumors: assessment of molecular heterogeneity using [68Ga]Ga-DOTA-TOC and [18F]FDG PET/CT
Evaluación de la heterogeneidad molecular en tumores neuroendocrinos mediante PET/TC con [68Ga]Ga-DOTA-TOC y [18F]FDG
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Z. Nogareda Seoanea,
Corresponding author
zulemanogareda@gmail.com

Corresponding author.
, M.C. Mallón Araújoa, A. Calatayud Cubesa, C. Barberán Corrala, Y. Domínguez Novoab, A. Cousillas Castiñeirac, N. Martínez Lagod, J.M. de Matías Leraltae, V. Pubul Nuñeza
a Servicio de Medicina Nuclear, Hospital Clínico Universitario Santiago de Compostela, Spain
b Servicio de Digestivo, Hospital Clínico Universitario Santiago de Compostela, Spain
c Servicio de Oncología Médica, Complejo Hospitalario Universitario de Pontevedra, Spain
d Servicio de Oncología Médica, Hospital Hospitalario Universitario de Ferrol, Spain
e Servicio de Endocrinología y Nutrición, Hospital Universitario Lucus Augusti, Lugo, Spain
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Tables (3)
Table 1. Characteristics of the patients.
Table 2. Number of lesions based on tumoral grade and radiopharmaceutical.
Table 3. Patients with mismatch lesions. (DOTA-TOC negative/FDG positive). +: positive; −:negative.
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Abstract
Objective

The aim of the study was evaluate the diagnostic performance of [68Ga]Ga-DOTA-TOC and [18F]FDG PET/CT in patients with histologically proven neuroendocrine tumors (NETs), as well as the correlation of the visualized findings with the tumor grade.

Material and methods

We included 50 patients with NETs who underwent both [68Ga]Ga-DOTA-TOC and [18F]FDG PET/TC. The pooled sensitivity of both scans was compared, as well as [68Ga]Ga-DOTA-TOC and [18F]FDG for each tumor grade (grade 1/G1, grade 2/G2 and grade 3/G3). Also, the sensitivity of [68Ga]Ga-DOTA-TOC and [18F]FDG as a function of the continuous variable Ki-67 was investigated. Finally, the number of lesions detected by both PET radiopharmaceuticals for each tumor grade was compared.

Results

The pooled sensitivity of both PET/CT (96%) was higher than [68Ga]Ga-DOTA-TOC (84%) and [18F]FDG (44%) separately, with statistically significant differences. The sensitivity of [68Ga]Ga-DOTA-TOC was higher than [18F]FDG in both G1 (p = 0.004) and G2 (p < 0.001). In G3 the performance of both scans detected disease in 100% of this subgroup. The sensitivity of [68Ga]Ga-DOTA-TOC and [18F]FDG PET/CT correlated significantly with the Ki-67 proliferative index. In G2 patients the number of lesions detected with [68Ga]Ga-DOTA-TOC was higher than [18F]FDG.

Conclusions

The performance of both PET/CT, particularly in G2 and G3, demonstrates the molecular heterogeneity of metastatic NETs and contributes to the selection of a more appropriate treatment, particularly in those high-grade patients who may benefit from radionuclide therapy (PRRT).

Keywords:
Neuroendocrine tumor
Somatostatin receptor
PET/CT
FDG
Resumen
Objetivo

El objetivo del estudio fue evaluar el rendimiento diagnóstico de las PET/TC con [68Ga]Ga-DOTA-TOC y [18F]FDG en pacientes con tumores neuroendocrinos (TNEs) confirmados histológicamente, así como la correlación de los hallazgos visualizados con el grado tumoral.

Material y métodos

Se incluyeron 50 pacientes con TNEs a los que se le realizó una PET/TC con [68Ga]Ga-DOTA-TOC y otra con [18F]FDG. Se comparó la sensibilidad conjunta de ambas exploraciones, así como la del [68Ga]Ga-DOTA-TOC y la de la [18F]FDG para cada grado tumoral (grado 1/G1, grado 2/G2 y grado 3/G3). Asimismo, se investigó la sensibilidad del [68Ga]Ga-DOTA-TOC y de la [18F]FDG en función de la variable continua Ki-67. Finalmente, se compararon el número de lesiones detectadas por cada radiofármaco PET para cada grado tumoral.

Resultados

La sensibilidad conjunta de ambas PET/TC (96%) fue mayor que la del [68Ga]Ga-DOTA-TOC (84%) y la [18F]FDG (44%) por separado, objetivándose diferencias significativas. La sensibilidad del [68Ga]Ga-DOTA-TOC fue superior a la [18F]FDG tanto en G1 (p = 0.004) como G2 (p < 0.001). En los G3 la realización de ambas exploraciones permitió detectar enfermedad en el 100% de este subgrupo. La sensibilidad de la PET/TC con [68Ga]Ga-DOTA-TOC y con [18F]FDG se correlaciona significativamente con el índice proliferativo Ki-67. En los pacientes G2 el número de lesiones detectadas con el [68Ga]Ga-DOTA-TOC fue superior a la [18F]FDG.

Conclusiones

La sensibilidad conjunta de ambas PET/TC es mayor que la del [68Ga]Ga-DOTA-TOC y [18F]FDG por separado y permite demostrar la heterogeidad molecular de los TNE metástásicos, sobre todo en aquellos pacientes G2 y G3.

Palabras clave:
Tumor neuroendocrino
Receptores de somatostatina
PET/TC
FDG

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