Characteristics of neuroendocrine neoplasm metastasis in somatostatin receptor PET/CT imaging: a retrospective analysis
Ling Wang, Guilan Hu, Zhen Qiao, Jingjing Zhang, Wei Zhang, Haiqun Xing, Tong Wang, Li Huo, Fang Li
Abstract
ObjectiveTo investigate the characteristics of NEN metastasis with SSTR PET/CT and to correlate the results with FDG-PET and pathology.
MethodsFrom November 2011 to August 2016, a total of 43 patients with NEN (18 males, 25 females; age range: 26-74 years) were recruited into this retrospective study; they underwent 68Ga-DOTA-TATE PET/CT (TATE-PET) imaging 40-60 min after 44.4-229.4 MBq 68Ga-DOTA-TATE administration. Metastases in 31 patients were confirmed by histopathology and in 12 patients by follow-up and other imaging modalities. Twenty-eight of 43 patients finished routine FDG-PET in a week after TATE-PET. PET/CT results were considered positive when the metastatic lesions were tracer-avid. ROI was drawn over each lesion for size and SUV measurement. χ2 test and Pearson correlation analysis were used for statistical analysis.
Results(1) Of 43 patients, TATE-PET detection rates of metastasis in the liver, lymph nodes, bones and lungs were 85.7%(30/35), 12/13, 7/7, 2/3, respectively, with their corresponding SUVmax of 18.1(11.3-23.3), 10.8(5.4-15.6), 7.7(4.2-9.9) and 1.8(1.3-2.3), respectively. Statistical correlation between size and SUVmax was found in metastatic bone lesions(r=0.233, P<0.05). (2) In 31 patients with histopathologically proven metastasis, TATE-PET detected 23/24(95.8%) G2, 1/2 G1 and 5/5 G3 metastases. G1 metastases were only found in the liver. (3)Among 28 patients underwent both TATE-PET and FDG-PET, there was no significant difference between the detecting rate of metastasis: 89.2%(25/28) vs 71.4%(20/28); χ2=2.389, P>0.05. Compared with FDG-PET, TATE-PET was superior in demonstrating metastasis in the liver and bones (70.0%(14/20) vs 65.0%(13/20), 3/3 vs 2/3), equal in detecting lung metastasis (both 2/3) but inferior in demonstrating metastasis in lymph nodes(9/10 vs 10/10).
ConclusionsThe capability of TATE-PET in revealing NEN metastasis varies depending on lesion localization and histologic grade. TATE-PET and FDG-PET are complementary to each other in detection of NEN metastasis, but without obvious relationship to histologic grade.
Key words:
Neuroendocrine tumors; Carcinoma, neuroendocrine; Neoplasm metastasis; Positron-emission tomography; Tomography, X-ray computed; Gallium radioisotopes; Octreotide; Deoxyglucose
Contributor Information
Ling Wang
Beijing Key Laboratory for Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Guilan Hu
Beijing Key Laboratory for Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Zhen Qiao
Beijing Key Laboratory for Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
Jingjing Zhang
Beijing Key Laboratory for Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Wei Zhang
Beijing Key Laboratory for Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Department of Nuclear Medicine, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
Haiqun Xing
Beijing Key Laboratory for Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Tong Wang
Beijing Key Laboratory for Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Li Huo
Beijing Key Laboratory for Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Fang Li
Beijing Key Laboratory for Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China