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Impact of initial imaging with gallium‐68 dotatate PET/CT on diagnosis and management of patients with neuroendocrine tumors
Author(s) -
Crown Angelena,
Rocha Flavio G.,
Raghu Preethi,
Lin Bruce,
Funk Gayle,
Alseidi Adnan,
Hubka Misho,
Rosales Joseph,
Lee Marie,
Kennecke Hagen
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25812
Subject(s) - medicine , neuroendocrine tumors , somatostatin receptor , positron emission tomography , radiology , pet ct , stage (stratigraphy) , somatostatin , octreotide , nuclear medicine , paleontology , biology
Background Somatostatin analog functional imaging with gallium‐68 (Ga‐68) dotatate positron emission tomography/computed tomography (PET/CT) has demonstrated superiority in lesion detection in patients with neuroendocrine tumors (NETs). The clinical impact of this imaging modality on US surgical and medical oncology practices has not been established. Methods Consecutive patients with NET at our institution who received an initial Ga‐68 dotatate PET/CT between July 2017 and September 2018 were included. Ga‐68 dotatate PET/CT was compared with prior imaging. Results Among 101 eligible patients, 51 of 50 were female/male, site of origin was gastroenteropancreatic (75%), unknown primary (13%), lung (8%), thymus (2%), and other (2%). All NETs were histologically well/moderately differentiated. Ga‐68 dotatate imaging findings altered management in 36 (35.6%) patients: documentation of progression led to the initiation of systemic therapy in 14 patients, obviated the need for biopsy in four patients, and altered surgical plans in 7 of 14 (50%) patients referred for surgery. In 11 patients, decisions regarding peptide receptor radionucleotide therapy and somatostatin analogs were altered. Conclusions In this series, Ga‐68 dotatate PET/CT altered diagnosis and management in one‐third of patients and changed operative plans in half of the patients who were referred for surgical evaluation. These results support the routine use of this imaging in the care of patients with early‐stage and advanced NETs.