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European Journal of Nuclear Medicine and Molecular Imaging

02-05-2024 | Positron Emission Tomography | Original Article

Preoperative assessment of lymph nodal metastases with [⁶⁸Ga]Ga-DOTATOC PET radiomics for improved surgical planning in well-differentiated pancreatic neuroendocrine tumours

Authors: Paola Mapelli, Carolina Bezzi, Francesca Muffatti, Samuele Ghezzo, Carla Canevari, Patrizia Magnani, Marco Schiavo Lena, Anna Battistella, Paola Scifo, Valentina Andreasi, Stefano Partelli, Arturo Chiti, Massimo Falconi, Maria Picchio

Published in: European Journal of Nuclear Medicine and Molecular Imaging

Abstract

Purpose

Accurate identification of lymph node (LN) metastases is pivotal for surgical planning of pancreatic neuroendocrine tumours (PanNETs); however, current imaging techniques have sub-optimal diagnostic sensitivity. Aim of this study is to investigate whether [⁶⁸Ga]Ga-DOTATOC PET radiomics might improve the identification of LN metastases in patients with non-functioning PanNET (NF-PanNET) referred to surgical intervention.

Methods

Seventy-two patients who performed preoperative [⁶⁸Ga]Ga-DOTATOC PET between December 2017 and March 2022 for NF-PanNET. [⁶⁸Ga]Ga-DOTATOC PET qualitative assessment of LN metastases was measured using diagnostic balanced accuracy (bACC), sensitivity (SN), specificity (SP), positive and negative predictive values (PPV, NPV). SUVmax, SUVmean, Somatostatin receptor density (SRD), total lesion SRD (TLSRD) and IBSI-compliant radiomic features (RFs) were obtained from the primary tumours. To predict LN involvement, these parameters were engineered, selected and used to train different machine learning models. Models were validated using tenfold repeated cross-validation and control models were developed. Models’ bACC, SN, SP, PPV and NPV were collected and compared (Kruskal–Wallis, Mann–Whitney).

Results

LN metastases were detected in 29/72 patients at histology. [⁶⁸Ga]Ga-DOTATOC PET qualitative examination of LN involvement provided bACC = 60%, SN = 24%, SP = 95%, PPV = 78% and NPV = 65%. The best-performing radiomic model provided a bACC = 70%, SN = 77%, SP = 61%, PPV = 60% and NPV = 83% (outperforming the control model, p < 0.05*).

Conclusion

In this study, [⁶⁸Ga]Ga-DOTATOC PET radiomics allowed to increase diagnostic sensitivity in detecting LN metastases from 24 to 77% in NF-PanNET patients candidate to surgery. Especially in case of micrometastatic involvement, this approach might assist clinicians in a better patients’ stratification.

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Title: Preoperative assessment of lymph nodal metastases with [68Ga]Ga-DOTATOC PET radiomics for improved surgical planning in well-differentiated pancreatic neuroendocrine tumours
Authors: Paola Mapelli
Carolina Bezzi
Francesca Muffatti
Samuele Ghezzo
Carla Canevari
Patrizia Magnani
Marco Schiavo Lena
Anna Battistella
Paola Scifo
Valentina Andreasi
Stefano Partelli
Arturo Chiti
Massimo Falconi
Maria Picchio
Publication date: 02-05-2024
Publisher: Springer Berlin Heidelberg
Keywords: Positron Emission Tomography
Metastasis
Published in: European Journal of Nuclear Medicine and Molecular Imaging
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-024-06730-w

At a glance: The STEP trials

Springer Medicine

Preoperative assessment of lymph nodal metastases with [⁶⁸Ga]Ga-DOTATOC PET radiomics for improved surgical planning in well-differentiated pancreatic neuroendocrine tumours

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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