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Capabilities of Combined Positron Emission and Computed Tomography in Neuroendocrine Tumor Diagnostics: First Experience of Russian Synthesis Module 68Ga-DOTA-TATE

Capabilities of Combined Positron Emission and Computed Tomography in Neuroendocrine Tumor Diagnostics: First Experience of Russian Synthesis Module 68Ga-DOTA-TATE

Tlostanova М.S., Khodzhibekova М.М., Panfilenko А.А., Balabanova А.А., Kostenikov N.А., Shatik S.V., Zaitsev V.V., Sysoev D.S., Stanzhevsky А.А., Granov А.М.
Key words: PET/CT; 68Ga-DOTA-TATE; neuroendocrine tumors; peptide synthesis module Gerat13–68Ga.
2016, volume 8, issue 4, page 51.

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The aim of the investigation was to estimate the sensitivity of combined positron emission and computed tomography (PET/CT) in the diagnostics, extension and treatment efficiency of neuroendocrine tumors (NET) using 68Ga-DOTA-TATE as an imaging agent.

Materials and Methods. PET/CT with 68Ga-DOTA-TATE was performed in 86 patients with pulmonary and gastrointestinal NET (55 patients underwent it preoperatively, 31 patients — postoperatively). All patients before PET/СТ were administered a diagnostic dose of radiopharmaceutical (RP) at the rate of 1.5 MBq per a kilogram of body mass but not less than 100 MBq. The developed RP synthesis module (Gerat13–68Ga) enabled to prepare a ready for intravenous administration 68Ga-DOTA-TATE within 15 min. Moreover, RP was defined to have a stably high radiochemical yield (over 50% without decay correction) and the appropriate quality. The patients were scanned 50–60 min after RP injection, the procedure being carried out according to a whole body protocol using PET/CT Discovery 690 (General Electric, USA). The data processing included the image analysis of computed and positron emission tomograms, as well as combined images. The main feature of sst-positive tissue tumor was pathological focal 68Ga-DOTA-TATE hyperfixation even if there were no evident structural changes of the organ according to CT findings. In cases when CT showed a tumor but the tumor didn't accumulated RP, its nature was considered to be malignant and the tumor was estimated as sst-negative.

Results. In patients examined before treatment, the sensitivity of PET/CT with 68Ga-DOTA-TATE to diagnose a primary tumor was 90.9% (50/55). In 3 patients PET showed a sst-negative tumor, in 2 patients a primary mass was not detected after tomography either. In addition, an initially determined stage of the disease was confirmed by PET/CT in 36 of 47 cases (76.6%). The rest patients were found to have second metastases in different organs and systems.

PET/CT findings in 13 of 31 patients examined after the treatment didn't coincide with those obtained by other techniques. In 6 patients the presence of pathological PR accumulation indicated no positive effect of the therapy, 3 patients were found to have secondary changes, 3 patients were detected to have a significant increase of liver metastases (only in CT), and 1 female patient after surgery appeared to have the disease recurrence in the stump of the left main bronchus.

Conclusion. PET/CT with 68Ga-DOTA-TATE demonstrated high efficiency in primary tumor detection, the assessment of therapy results and NET extension.

  1. Yao J.C., Hassan M., Phan A., Dagohoy C., Leary C., Mares J.E., Abdalla E.K., Fleming J.B., Vauthey J.N., Rashid A., Evans D.B. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 2008; 26(18): 3063–3072, https://doi.org/10.1200/jco.2007.15.4377.
  2. Hauso O., Gustafsson B.I., Kidd M., Waldum H.L., Drozdov I., Chan A.K., Modlin I.M. Neuroendocrine tumor epidemiology: contrasting Norway and North America. Cancer 2008; 113(10): 2655–2664, https://doi.org/10.1002/cncr.23883.
  3. Stridsberg M., Oberg K., Li Q., Engstrom U., Lundqvist G. Measurements of chromogranin A, chromogranin B (secretogranin I), chromogranin C (secretogranin II) and pancreastatin in plasma and urine from patients with carcinoid tumours and endocrine pancreatic tumours. J Endocrinol 1995; 144(1): 49–59, https://doi.org/10.1677/joe.0.1440049.
  4. Barakat M.T., Meeran K., Bloom S.R. Neuroendocrine tumours. Endocr Relat Cancer 2004; 11(1): 1–18, https://doi.org/10.1677/erc.0.0110001.
  5. Kasprzak A., Zabel M., Biczysko W. Selected markers (chromogranin A, neuron-specific enolase, synaptophysin, protein gene product 9.5) in diagnosis and prognosis of neuroendocrine pulmonary tumours. Pol J Pathol 2007; 58(1): 23–33.
  6. Kulke M.H. Neuroendocrine tumours: clinical presentation and management of localized disease. Cancer Treat Rev 2003; 29(5): 363–370, https://doi.org/10.1016/s0305-7372(03)00072-0.
  7. Rindi G., Klöppel G. Endocrine tumors of the gut and pancreas tumor biology and classification. Neuroendocrinology 2004; 80(Suppl 1): 12–15, https://doi.org/10.1159/000080733.
  8. Tlostanova M.S., Petrunkin A.M. The effectiveness of pet with 18F-fluorodesoxyglucose in the diagnosis of lung neuroendocrine tumors. Voprosy onkologii 2013; 59(4): 505–508.
  9. Abgral R., Leboulleux S., Déandreis D., Aupérin A., Lumbroso J., Dromain C., Duvillard P., Elias D., de Baere T., Guigay J., Ducreux M., Schlumberger M., Baudin E. Performance of 18fluorodeoxyglucose-positron emission tomography and somatostatin receptor scintigraphy for high Ki67 (≥10%) well-differentiated endocrine carcinoma staging. J Clin Endocrinol Metab 2011; 96(3): 665–671, https://doi.org/10.1210/jc.2010-2022.
  10. Öberg K., Hellman P., Kwekkeboom D., Jelic S.; ESMO Guidelines Working Group. Neuroendocrine bronchial and thymic tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010; 21(Suppl 5): v220–v222, https://doi.org/10.1093/annonc/mdq191.
  11. Severi S., Nanni O., Bodei L., Sansovini M., Ianniello A., Nicoletti S., Scarpi E., Matteucci F., Gilardi L., Paganelli G. Role of 18FDG PET/CT in patients treated with 177Lu-DOTATATE for advanced differentiated neuroendocrine tumours. Eur J Nucl Med Mol Imaging 2013; 40(6): 881–888, https://doi.org/10.1007/s00259-013-2369-z.
  12. Kodina G.E., Kozlova M.D., Krasnov N.N., Malinin A.B., Sevast’yanov Yu.G., Sevast’yanova A.S., Razbash A.A., Sharygin L.M. Radionuklidnyy generator 68Ge/68Ga dlya polucheniya fiziologicheski priemlemogo rastvora [Radionuclide generator 68Ge/68Ga for preparing a physically acceptable solution]. Patent RF No.2126271. 1998.
  13. Larenkov A.A., Kodina G.E., Bruskin A.B. Gallium radionuclides in nuclear medicine: radiopharmaceuticals based on 68Ga. Meditsinskaya radiologiya i radiatsionnaya bezopasnost’ 2011; 56(5): 56–73.
  14. Wild D., Bomanji J.B., Benkert P., Maecke H., Ell P.J., Reubi J.C., Caplin M.E. Comparison of 68Ga-DOTANOC and 68Ga-DOTATATE PET/CT within patients with gastroenteropancreatic neuroendocrine tumors. J Nucl Med 2013; 54(3): 364–372, https://doi.org/10.2967/jnumed.112.111724.
  15. Poeppel T.D., Binse I., Petersenn S., Lahner H., Schott M., Antoch G., Brandau W., Bockisch A., Boy C. Differential uptake of 68Ga-DOTATOC and 68Ga-DOTATATE in PET/CT of gastroenteropancreatic neuroendocrine tumors. Recent Results Cancer Res 2013; 194: 353–371, https://doi.org/10.1007/978-3-642-27994-2_18.
  16. Poeppel T.D., Binse I., Petersenn S., Lahner H., Schott M., Antoch G., Brandau W., Bockisch A., Boy C. 68Ga-DOTATOC versus 68Ga-DOTATATE PET/CT in functional imaging of neuroendocrine tumors. J Nucl Med 2011; 52(12): 1864–1870, https://doi.org/10.2967/jnumed.111.091165.

Tlostanova М.S., Khodzhibekova М.М., Panfilenko А.А., Balabanova А.А., Kostenikov N.А., Shatik S.V., Zaitsev V.V., Sysoev D.S., Stanzhevsky А.А., Granov А.М. Capabilities of Combined Positron Emission and Computed Tomography in Neuroendocrine Tumor Diagnostics: First Experience of Russian Synthesis Module 68Ga-DOTA-TATE. Sovremennye tehnologii v medicine 2016; 8(4): 51, https://doi.org/10.17691/stm2016.8.4.07


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