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European Journal of Nuclear Medicine and Molecular Imaging

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01-03-2012 | Original Article

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

Authors: Aurora Sainz-Esteban, Vikas Prasad, Christiane Schuchardt, Carolin Zachert, José Manuel Carril, Richard P. Baum

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 3/2012

Abstract

Purpose

The aim of the study was to compare sequential ¹⁷⁷Lu-DOTA-TATE planar scans (¹⁷⁷Lu-DOTA-TATE) in patients with metastasized neuroendocrine tumours (NET) acquired during peptide receptor radionuclide therapy (PRRT) for dosimetry purposes with the pre-therapeutic ⁶⁸Ga-DOTA-TATE positron emission tomography (PET)/CT (⁶⁸Ga-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 ⁶⁸Ga-DOTA-TATE and ¹⁷⁷Lu-DOTA-TATE imaging within 7.9 ± 7.5 days between the two examinations. ¹⁷⁷Lu-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 ¹⁷⁷Lu-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 ⁶⁸Ga-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 ⁶⁸Ga-DOTA-TATE positive and ¹⁷⁷Lu-DOTA-TATE negative, whereas 9 were ⁶⁸Ga-DOTA-TATE negative and ¹⁷⁷Lu-DOTA-TATE positive. The sensitivity, positive predictive value and accuracy for ¹⁷⁷Lu-DOTA-TATE as compared to ⁶⁸Ga-DOTA-TATE were 91, 97 and 88%, respectively. Significantly more lesions were seen on the delayed (72 h) ¹⁷⁷Lu-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 ¹⁷⁷Lu-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 ¹⁷⁷Lu-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 ⁶⁸Ga-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.

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Title: 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
Authors: Aurora Sainz-Esteban
Vikas Prasad
Christiane Schuchardt
Carolin Zachert
José Manuel Carril
Richard P. Baum
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 3/2012
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-011-2003-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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