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01-02-2020 | Magnetic Resonance Imaging | Original Scientific Report

Should ⁶⁸Ga-DOTATATE PET/CT be Performed Routinely in Patients with Neuroendocrine Tumors Before Surgical Resection?

Authors: Nasim T. Babazadeh, Devan J. Schlund, Tyler Cornelius, Jagadeesh S. Singh, John F. Tierney, Meri Chen, Xavier M. Keutgen

Published in: World Journal of Surgery | Issue 2/2020

Abstract

Background

The only potential cure for neuroendocrine tumors (NETs) is operative resection, which may also offer a survival benefit for advanced disease. We aimed to assess the role of ⁶⁸Ga-DOTATATE PET/CT in preoperative planning and compared its performance to CT with IV contrast and MRI with Eovist^®, for abdominal NETs.

Methods

Records of patients who underwent ⁶⁸Ga-DOTATATE PET/CT in addition to MRI with Eovist^® and/or CT with IV contrast were retrospectively evaluated. The effect of imaging findings on surgical management and characteristics of detected lesions were analyzed. Descriptive statistics were used.

Results

Of 21 patients who underwent ⁶⁸Ga-DOTATATE PET/CT prior to surgical resection, five (24%) had a change in surgical management due to findings. In three patients, ⁶⁸Ga-DOTATATE PET/CT identified the primary tumor. In two patients, ⁶⁸Ga-DOTATATE PET/CT helped clarify equivocal hepatic lesions seen on MRI with Eovist^®. MRI with Eovist^® had the highest number of lesions found (median 13, versus 9 on CT and 9.5 on ⁶⁸Ga-DOTATATE PET/CT). DOTATATE-avid lesions were on average larger than lesions seen only on MRI with Eovist^® (1.6 cm versus 0.6 cm, p = 0.0002). The optimal cutoff point for detection by ⁶⁸Ga-DOTATATE PET/CT was a size of 0.95 cm, with a sensitivity of 56% and specificity of 98%.

Conclusions

Preoperative ⁶⁸Ga-DOTATATE PET/CT is useful only in a subset of patients undergoing surgical resection for NETs. MRI with Eovist^® is superior at identifying liver metastases when compared to ⁶⁸Ga-DOTATATE PET/CT and should therefore be used routinely before hepatic cytoreduction of NETs.

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Title: Should 68Ga-DOTATATE PET/CT be Performed Routinely in Patients with Neuroendocrine Tumors Before Surgical Resection?
Authors: Nasim T. Babazadeh
Devan J. Schlund
Tyler Cornelius
Jagadeesh S. Singh
John F. Tierney
Meri Chen
Xavier M. Keutgen
Publication date: 01-02-2020
Publisher: Springer International Publishing
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Computed Tomography
Metastasis
Computed Tomography
Neuroendocrine Tumor
Published in: World Journal of Surgery / Issue 2/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05216-3

At a glance: The STEP trials

Springer Medicine

Should ⁶⁸Ga-DOTATATE PET/CT be Performed Routinely in Patients with Neuroendocrine Tumors Before Surgical Resection?

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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