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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 5/2014

01-05-2014 | Original Article

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

Authors: Balasubramanian Venkitaraman, Sellam Karunanithi, Arvind Kumar, G. C. Khilnani, Rakesh Kumar

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 5/2014

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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.
Literature
1.
Klöppel G. Tumour biology and histopathology of neuroendocrine tumours. Best Pract Res Clin Endocrinol Metab 2007;21:15–31.PubMedCrossRef
2.
Beasley MB, Brambilla E, Travis WD. The 2004 World Health Organization classification of lung tumors. Semin Roentgenol 2005;40:90–7.PubMedCrossRef
3.
Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer 2003;97:934–59.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
13.
McCaughan BC, Martini N, Bains MS. Bronchial carcinoids. Review of 124 cases. J Thorac Cardiovasc Surg 1985;89:8–17.PubMed
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.PubMedCrossRef
15.
Rosado de Christenson ML, Abbott GF, Kirejczyk WM, Galvin JR, Travis WD. Thoracic carcinoids: radiologic-pathologic correlation. Radiographics 1999;19:707–36.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCentralPubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
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.PubMedCrossRef
Metadata
Title
Role of 68Ga-DOTATOC PET/CT in initial evaluation of patients with suspected bronchopulmonary carcinoid
Authors
Balasubramanian Venkitaraman
Sellam Karunanithi
Arvind Kumar
G. C. Khilnani
Rakesh Kumar
Publication date
01-05-2014
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 5/2014
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-013-2659-5

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