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Purpose: The aim of the study was to compare sequential (177)Lu-DOTA-TATE planar scans ((177)Lu-DOTA-TATE) in patients with metastasized neuroendocrine tumours (NET) acquired during peptide receptor radionuclide therapy (PRRT) for dosimetry purposes with the pre-therapeutic (68)Ga-DOTA-TATE positron emission tomography (PET)/CT ((68)Ga-DOTA-TATE) maximum intensity projection (MIP) images obtained in the same patients concerning the sensitivity of the different methods.

Methods: A total of 44 patients (59 ± 11 years old) with biopsy-proven NET underwent (68)Ga-DOTA-TATE and (177)Lu-DOTA-TATE imaging within 7.9 ± 7.5 days between the two examinations. (177)Lu-DOTA-TATE planar images were acquired at 0.5, 2, 24, 48 and 72 h post-injection; lesions were given a score from 0 to 4 depending on the uptake of the radiopharmaceutical (0 being lowest and 4 highest). The number of tumour lesions which were identified on (177)Lu-DOTA-TATE scans (in relation to the acquisition time after injection of the therapeutic dose as well as with regard to the body region) was compared to those detected on (68)Ga-DOTA-TATE studies obtained before PRRT.

Results: A total of 318 lesions were detected; 280 (88%) lesions were concordant. Among the discordant lesions, 29 were (68)Ga-DOTA-TATE positive and (177)Lu-DOTA-TATE negative, whereas 9 were (68)Ga-DOTA-TATE negative and (177)Lu-DOTA-TATE positive. The sensitivity, positive predictive value and accuracy for (177)Lu-DOTA-TATE as compared to (68)Ga-DOTA-TATE were 91, 97 and 88%, respectively. Significantly more lesions were seen on the delayed (72 h) (177)Lu-DOTA-TATE images (91%) as compared to the immediate (30 min) images (68%). The highest concordance was observed for bone metastases (97%) and the lowest for head/neck lesions (75%). Concordant lesions (n = 77; mean size 3.8 cm) were significantly larger than discordant lesions (n = 38; mean size 1.6 cm) (p < 0.05). No such significance was found for differences in maximum standardized uptake value (SUV(max)). However, concordant liver lesions with a score from 1 to 3 in the 72-h (177)Lu-DOTA-TATE scan had a lower SUV(max) (n = 23; mean 10.9) than those metastases with a score of 4 (n = 97; mean SUV(max) 18) (p < 0.05).

Conclusion: Although (177)Lu-DOTA-TATE planar dosimetry scans exhibited a very good sensitivity for the detection of metastases, they failed to pick up 9% of lesions seen on the (68)Ga-DOTA-TATE PET/CT. Three-dimensional dosimetry using single photon emission computed tomography/CT could be applied to investigate this issue further. Delayed (72 h) images are most suitable for drawing regions of interest for dosimetric calculations.

Titel:	Comparison of sequential planar 177Lu-DOTA-TATE dosimetry scans with 68Ga-DOTA-TATE PET/CT images in patients with metastasized neuroendocrine tumours undergoing peptide receptor radionuclide therapy.
Autor/in / Beteiligte Person:	Sainz-Esteban, A ; Prasad, V ; Schuchardt, C ; Zachert, C ; Carril, JM ; Baum, RP
Link:	Full Text Finder (Volltext)
Zeitschrift:	European journal of nuclear medicine and molecular imaging, Jg. 39 (2012-03-01), Heft 3, S. 501-11
Veröffentlichung:	Berlin : Springer-Verlag Berlin, 2002-, 2012
Medientyp:	academicJournal
ISSN:	1619-7089 (electronic)
DOI:	10.1007/s00259-011-2003-x
Schlagwort:	Adult Aged Aged, 80 and over Female Humans Male Middle Aged Neoplasm Metastasis Neuroendocrine Tumors pathology Radiometry Retrospective Studies Time Factors Young Adult Multimodal Imaging methods Neuroendocrine Tumors diagnostic imaging Neuroendocrine Tumors radiotherapy Octreotide analogs & derivatives Organometallic Compounds Positron-Emission Tomography Receptors, Peptide therapeutic use Tomography, X-Ray Computed
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Comparative Study; Journal Article Language: English [Eur J Nucl Med Mol Imaging] 2012 Mar; Vol. 39 (3), pp. 501-11. <i>Date of Electronic Publication: </i>2011 Dec 20. MeSH Terms: Organometallic Compounds* ; Positron-Emission Tomography* ; Tomography, X-Ray Computed* ; Multimodal Imaging / methods ; Neuroendocrine Tumors / diagnostic imaging ; Neuroendocrine Tumors / radiotherapy ; Octreotide / analogs & derivatives ; Receptors, Peptide / *therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neuroendocrine Tumors / pathology ; Radiometry ; Retrospective Studies ; Time Factors ; Young Adult References: Eur J Nucl Med Mol Imaging. 2009 Jan;36(1):48-52. (PMID: 18807033) ; Eur J Nucl Med Mol Imaging. 2004 Oct;31(10):1386-92. (PMID: 15175836) ; Nucl Med Biol. 2010 Apr;37(3):265-75. (PMID: 20346866) ; Eur J Nucl Med Mol Imaging. 2007 Jul;34(7):982-93. (PMID: 17225119) ; Eur J Nucl Med Mol Imaging. 2010 Jan;37(1):67-77. (PMID: 19618183) ; Semin Nucl Med. 2010 Mar;40(2):78-88. (PMID: 20113677) ; Endocr Rev. 2003 Aug;24(4):389-427. (PMID: 12920149) ; Lancet Oncol. 2008 Jan;9(1):61-72. (PMID: 18177818) ; Recent Results Cancer Res. 2008;170:225-42. (PMID: 18019630) ; Eur J Nucl Med Mol Imaging. 2003 Mar;30(3):417-22. (PMID: 12634971) ; Clin Nucl Med. 2010 Jan;35(1):40-1. (PMID: 20026975) ; J Nucl Med. 2010 Jun;51(6):875-82. (PMID: 20484441) ; J Nucl Med. 2007 Oct;48(10):1741-8. (PMID: 17873136) ; Eur J Nucl Med Mol Imaging. 2007 Aug;34(8):1219-27. (PMID: 17260141) ; Oncology. 2011;80(5-6):326-9. (PMID: 21791941) ; J Clin Oncol. 2008 May 1;26(13):2124-30. (PMID: 18445841) ; Eur J Nucl Med. 2000 Mar;27(3):273-82. (PMID: 10774879) ; Appl Radiat Isot. 2009 Feb;67(2):227-33. (PMID: 19027307) ; Semin Nucl Med. 2009 Jul;39(4):264-75. (PMID: 19497403) ; Eur J Nucl Med Mol Imaging. 2004 Aug;31(8):1097-104. (PMID: 15029459) ; Eur J Nucl Med Mol Imaging. 2003 Apr;30(4):510-8. (PMID: 12582815) ; Eur J Nucl Med Mol Imaging. 2010 Feb;37(2):212-25. (PMID: 19727718) ; Eur J Nucl Med Mol Imaging. 2011 Sep;38(9):1659-68. (PMID: 21626438) ; Eur J Nucl Med. 2001 Sep;28(9):1319-25. (PMID: 11585290) ; Best Pract Res Clin Endocrinol Metab. 2007 Mar;21(1):111-29. (PMID: 17382268) ; Acad Radiol. 2010 Mar;17(3):291-7. (PMID: 19962915) ; J Nucl Med. 2007 Apr;48(4):508-18. (PMID: 17401086) ; Semin Nucl Med. 2006 Jul;36(3):228-47. (PMID: 16762613) ; J Nucl Med. 2009 Dec;50(12):1927-32. (PMID: 19910422) ; Eur J Nucl Med Mol Imaging. 2006 Nov;33(11):1346-51. (PMID: 16847654) ; Cancer. 2008 Jun;112(11):2447-55. (PMID: 18383518) ; Eur J Nucl Med Mol Imaging. 2011 Sep;38(9):1669-74. (PMID: 21559978) Substance Nomenclature: 0 (Organometallic Compounds) ; 0 (Receptors, Peptide) ; 9L17Y0H71P (gallium Ga 68 dotatate) ; AE221IM3BB (lutetium Lu 177 dotatate) ; RWM8CCW8GP (Octreotide) Entry Date(s): Date Created: 20111221 Date Completed: 20120615 Latest Revision: 20220408 Update Code: 20231215

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Comparison of sequential planar 177Lu-DOTA-TATE dosimetry scans with 68Ga-DOTA-TATE PET/CT images in patients with metastasized neuroendocrine tumours undergoing peptide receptor radionuclide therapy.