Diagnostic performance and impact on patient management of [68Ga]Ga-DOTA-TOC PET/CT in colorectal neuroendocrine tumors derived from hindgut |
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| Authors: | Pierre Delabie,É ric Baudin,Olivia Hentic,Pauline Afchain,Timofei Rusu,Franç oise Montravers |
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| Affiliation: | a Department of Nuclear Medicine, Hôpital Tenon AP-HP, Sorbonne Université, Paris, France;b Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy, Villejuif, France;c Department of Gastroenterology and Pancreatology, Hôpital Beaujon AP-HP, Université de Paris, Clichy, France;d Department of Oncology, Hôpital Saint-Antoine AP-HP, Sorbonne Université, Paris, France. |
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| Abstract: | The main purpose of this retrospective study was to determine the diagnostic performance of [68Ga]Ga-DOTA-D-Phe1-Try3-octreotide(DOTA-TOC) positron emission tomography/computed tomography (PET/CT) in patients with well-differentiated colorectal Neuroendocrine Tumours (NETs) originating from the hindgut. The other aims were to assess the impact of the examination on patient management and to analyze the results of 2-[18F]FDG and/or 6-[18F]FDOPA PET/CT when they were performed. [68Ga]Ga-DOTA-TOC PET/CT and clinical data from 30 patients with biopsy-proven well-differentiated NETs originating from the hindgut were retrospectively reviewed and analyzed by comparing the [68Ga]Ga-DOTA-TOC PET/CT findings with pathological and/or follow-up data. We also compared the [68Ga]Ga-DOTA-TOC PET/CT results with 2-[18F]FDG and/or 6-[18F]FDOPA PET/CT results in 6 patients. The impact on management was determined in hindsight by comparing the patient management decided before and after the TEP examination based on data from multidisciplinary team meetings. On a patient basis, [68Ga]Ga-DOTA-TOC PET/CT was accurate in 30 of the 30 examinations. [68Ga]Ga-DOTA-TOC PET/CT correctly identified the primary tumor in all patients with primary tumors not resected before the examination and allowed the detection of unexpected distant metastases in 36% of the patients referred for initial staging. [68Ga]Ga-DOTA-TOC PET/CT findings affected patient management in 57% of cases with generally major intermodality changes. Intraindividual comparison of the results of the different PET radiopharmaceuticals showed a clear superiority of [68Ga]Ga-DOTA-TOC PET/CT considering both the number of lesions and the intensity of uptake. [68Ga]Ga-DOTA-TOC PET/CT is an accurate imaging modality for the assessment of well-differentiated colorectal NETs that highly impact patient management. Thus, we suggest that [68Ga]Ga-DOTA-TOC PET/CT be employed as a first choice for the assessment of these tumors in nuclear medicine. |
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| Keywords: | colorectal neuroendocrine tumours oncology PET imaging somatostatin receptors |
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