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Detection rate of unknown primary tumour by using somatostatin receptor PET/CT in patients with metastatic neuroendocrine tumours: a meta-analysis

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Abstract

Purpose

The high diagnostic performance of somatostatin receptor positron emission tomography with computed tomography (PET/CT) in neuroendocrine tumours (NETs) was demonstrated by several articles. However, only some studies evaluated the detection rate (DR) of this imaging method in patients with metastatic NETs and unknown primary tumours (CUP-NETs). Therefore, we aimed to perform a meta-analysis to add evidence-based data in this setting.

Methods

A comprehensive computer literature search of studies listed in PubMed/MEDLINE, EMBASE, and Cochrane library databases through December 2018 and regarding the use of somatostatin receptor PET/CT in patients with CUP-NETs was carried out. Pooled DR of CUP-NETs by using somatostatin receptor PET/CT was calculated. A pooled analysis evaluating the percentage of change of management by using somatostatin receptor PET/CT in these patients was also performed.

Results

Twelve studies on the use of somatostatin receptor PET/CT in detecting CUP-NETs in 383 metastatic patients were included. The meta-analysis of all these studies provided the following DR on a per patient-based analysis: 56% (95% confidence interval (95% CI): 48–63%). Moderate heterogeneity among the selected studies was found (I2 = 50%), whereas a significant publication bias was excluded by Egger’s test (p = 0.45). The most common primary tumour sites were the bowel and the pancreas. A change of management by using somatostatin receptor PET/CT was demonstrated in 20% (95% CI: 10–33%) of patients with CUP-NET.

Conclusions

Somatostatin receptor PET/CT is very useful in detecting CUP-NETs in patients with metastatic disease. More studies on the change of management by using this imaging method in this setting are needed.

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Acknowledgements

We thank all the staff of the Clinical Trial Unit of Ente Ospedaliero Cantonale for their support. The Clinical Trail Unit of Ente Ospedaliero Cantonale was in charge of literature search, statistical analysis and manuscript writing.

Funding

This study was performed through a funded activity of the Clinical Trial Unit of Ente Ospedaliero Cantonale.

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Authors and Affiliations

  1. Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland

    Sara De Dosso, Ricardo Pereira Mestre & Piercarlo Saletti

  2. Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland

    Giorgio Treglia & Luca Giovanella

  3. Health Technology Assessment Unit, Ente Ospedaliero Cantonale, Bellinzona, Switzerland

    Giorgio Treglia

  4. Clinical Trial Unit, Ente Ospedaliero Cantonale, Bellinzona, Switzerland

    Giorgio Treglia & Mariarosa Pascale

  5. Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland

    Giorgio Treglia

  6. Clinic of Internal Medicine, Ente Ospedaliero Cantonale, Lugano, Switzerland

    Adriana Tamburello

  7. Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MA, USA

    Prasanna Santhanam

  8. Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria

    Alexander S. Kroiss

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  1. Sara De Dosso
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Correspondence to Giorgio Treglia.

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*Sara De Dosso and Giorgio Treglia share the first authorship.

**Piercarlo Saletti and Luca Giovanella share the last authorship.

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De Dosso, S., Treglia, G., Pascale, M. et al. Detection rate of unknown primary tumour by using somatostatin receptor PET/CT in patients with metastatic neuroendocrine tumours: a meta-analysis. Endocrine 64, 456–468 (2019). https://doi.org/10.1007/s12020-019-01934-9

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