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Objective  To evaluate the diagnostic efficacy of  18 F-AlF-NOTA-octreotide ( 18 F-OC) PET/CT compared with that of  68 Ga-DOTATATE PET/CT.    Materials and methods  Twenty patients (mean age: 52.65 years, range: 24–70 years) with biopsy-proven neuroendocrine neoplasms (NENs) were enrolled in this prospective study. We compared the biodistribution profiles in normal organs based on the maximum standard uptake value (SUV max ) and mean standard uptake value (SUV mean ), and uptake in NEN lesions by measuring the SUV max  on  18 F-OC and  68 Ga-DOTATATE PET/CT images. The tumor-to-liver ratio (TLR) and tumor-to-spleen ratio were calculated by dividing the SUV max  of different tumor lesions by the SUV mean  of the liver and spleen, respectively. The Wilcoxon signed-rank test was used to compare nonparametric data. Data were expressed as the median (interquartile range).    Results  In most organs, there were no significant differences in the biodistribution of  68 Ga-DOTATATE and  18 F-OC.  18 F-OC had significantly lower uptake in the salivary glands and liver than  68 Ga-DOTATATE.  18 F-OC detected more lesions than  68 Ga-DOTATATE. The uptake of  18 F-OC in the tumors was higher in most patients, but the difference was not statistically significant relative to that of  68 Ga-DOTATATE. However, the TLRs of  18 F-OC were higher in most patients, including for lesions in the liver ( p  = 0.02) and lymph nodes ( p  = 0.02).    Conclusion  Relative to  68 Ga-DOTATATE,  18 F-OC possesses favorable characteristics with similar image quality and satisfactory NEN lesion detection rates, especially in the liver due to its low background uptake.  18 F-OC therefore offers a promising clinical alternative for  68 Ga-DOTATATE.    Supplementary Information  The online version contains supplementary material available at 10.1186/s13550-021-00797-4.

Evaluation of 18F-AlF-NOTA-octreotide for imaging neuroendocrine neoplasms: comparison with 68Ga-DOTATATE PET/CT