Journal article
64Cu-DOTATATE PET for Neuroendocrine Tumors: a Prospective Head-to-Head Comparison with 111In-DTPA-octreotide in 112 Patients
Neuroendocrine tumors (NETs) can be visualized using radiolabeled somatostatin analogs. We have previously shown the clinical potential of (64)Cu-DOTATATE in a small first-in-human feasibility study. The aim of the present study was, in a larger prospective design, to compare on a head-to-head basis the performance of (64)Cu-DOTATATE and (111)In-diethylenetriaminepentaacetic acid (DTPA)-octreotide ((111)In-DTPA-OC) as a basis for implementing (64)Cu-DOTATATE as a routine.
METHODS: We prospectively enrolled 112 patients with pathologically confirmed NETs of gastroenteropancreatic or pulmonary origin. All patients underwent both PET/CT with (64)Cu-DOTATATE and SPECT/CT with (111)In-DTPA-OC within 60 d. PET scans were acquired 1 h after injection of 202 MBq (range, 183-232 MBq) of (64)Cu-DOTATATE after a diagnostic contrast-enhanced CT scan.
Patients were followed for 42-60 mo for evaluation of discrepant imaging findings. The McNemar test was used to compare the diagnostic performance. RESULTS: Eighty-seven patients were congruently PET- and SPECT-positive. No SPECT-positive cases were PET-negative, whereas 10 false-negative SPECT cases were identified using PET.
The diagnostic sensitivity and accuracy of (64)Cu-DOTATATE (97% for both) were significantly better than those of (111)In-DTPA-OC (87% and 88%, respectively, P = 0.017). In 84 patients (75%), (64)Cu-DOTATATE identified more lesions than (111)In-DTPA-OC and always at least as many. In total, twice as many lesions were detected with (64)Cu-DOTATATE than with (111)In-DTPA-OC.
Moreover, in 40 of 112 cases (36%) lesions were detected by (64)Cu-DOTATATE in organs not identified as disease-involved by (111)In-DTPA-OC. CONCLUSION: With these results, we demonstrate that (64)Cu-DOTATATE is far superior to (111)In-DTPA-OC in diagnostic performance in NET patients. Therefore, we do not hesitate to recommend implementation of (64)Cu-DOTATATE as a replacement for (111)In-DTPA-OC.
Language: | English |
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Publisher: | Society of Nuclear Medicine |
Year: | 2015 |
Pages: | 847-854 |
ISSN: | 15355667 , 01615505 and 2159662x |
Types: | Journal article |
DOI: | 10.2967/jnumed.115.156539 |
ORCIDs: | Elema, Dennis Ringkjøbing , 0000-0001-9732-9192 and 0000-0002-2706-5547 |
111In-DTPA-octreotide 64Cu-DOTATATE Adult Aged Aged, 80 and over Biopsy Clinical Investigations Female Humans Image Processing, Computer-Assisted Male Middle Aged Multimodal Imaging Neoplasm Metastasis Neuroendocrine Tumors Octreotide Organometallic Compounds PET PET/CT Pentetic Acid Positron-Emission Tomography Prospective Studies Receptors, Somatostatin SPECT Stomach Neoplasms Tomography, Emission-Computed, Single-Photon Tomography, X-Ray Computed cancer indium-111-octreotide molecular imaging neuroendocrine tumors prospective somatostatin receptor imaging