68Ga-DOTATATE and 18F-FDG PET/CT dual-modality imaging enhances precision of staging and treatment decision for gastroenteropancreatic neuroendocrine neoplasms.
10.12122/j.issn.1673-4254.2025.06.10
- Author:
Xiaoxiang ZHANG
1
;
Ying TIAN
1
;
Lilan FU
1
;
Yin ZHANG
1
;
Ye DONG
1
;
Fei XIE
1
;
Li CHEN
1
;
Yanchao HUANG
1
;
Hubing WU
1
;
Jianer TAN
1
Author Information
1. PET Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
- Publication Type:Journal Article
- Keywords:
X-ray computed;
fluorodeoxyglucose F18;
gallium radioisotope Ga68;
neuroendocrine tumors;
octreotide;
positron emission tomography;
somatostatin receptor;
tomography
- MeSH:
Humans;
Positron Emission Tomography Computed Tomography/methods*;
Neuroendocrine Tumors/therapy*;
Pancreatic Neoplasms/therapy*;
Retrospective Studies;
Organometallic Compounds;
Stomach Neoplasms/therapy*;
Neoplasm Staging;
Fluorodeoxyglucose F18;
Intestinal Neoplasms/therapy*;
Female;
Male;
Middle Aged;
Aged;
Adult
- From:
Journal of Southern Medical University
2025;45(6):1212-1219
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To evaluate the value of ⁶⁸Ga-DOTATATE and ¹⁸F-FDG PET/CT imaging in staging and treatment decision for gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN).
METHODS:This retrospective analysis was conducted in 49 patients with GEP-NEN undergoing 18F-FDG and 68Ga-DOTATATE PET/CT imaging at our hospital from August, 2020 to March, 2023, including 34 newly diagnosed patients and 15 patients with recurrence or metastasis after treatment. GEP-NEN were classified into G1, G2, and G3 neuroendocrine tumors (NET) and neuroendocrine carcinomas (NEC) based on pathological typing. The detection efficiency were classified into 4 patterns based on the number of positive tumor lesions detected by the two tracers: 68Ga-DOTATATE>18F-FDG (A); 68Ga-DOTATATE=18F-FDG (B); 68Ga-DOTATATE<18F-FDG (C); and complementation (D). The value of dual-modality imaging in staging and treatment decision were evaluated by visual analysis.
RESULTS:In the 49 patients with GEP-NEN, 68Ga-DOTATATE PET/CT was superior to 18F-FDG PET/CT for detecting systemic tumor lesions (P<0.001) and more sensitive for detecting primary/recurrent lesions, lymph node metastasis, liver metastasis, and bone metastasis (P<0.05), while 18F-FDG PET/CT had higher detection rates for lung metastasis and peritoneal metastasis (P<0.05). In terms of the detection efficiency, Pattern A was found in 46.9% (23/49) patients, Pattern B in 38.8% (19/49), Pattern C in 12.2% (6/49), and Pattern D in 2.0% (1/49). The complementary value of ¹⁸F-FDG PET/CT to ⁶⁸Ga-DOTATATE PET/CT was 0% in G1 NET patients (0/13), 8.3% in G2 NET patients (2/24), 50% in G3 NET patients (3/6), and 33.3% in NEC patients (2/6). 12.2% (6/49) of the patients had their staging confirmed or changed due to additional lesions detected by ¹⁸F-FDG PET/CT imaging, resulting subsequently in establishment or adjustment of their treatment plans.
CONCLUSIONS:68Ga-DOTATATE PET/CT imaging should be the primary choice for GEP-NEN patients. Additional ¹⁸F-FDG PET/CT imaging can potentially improve precision of staging and treatment decision-making for G2, G3 and NEC patients but provides virtually no clinical benefits for G1 NET patients.
