Head-to-Head Comparison of SSTR Antagonist [68Ga]Ga-DATA5m-LM4 with SSTR Agonist [68Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study

Viswanathan, Rahul; Ballal, Sanjana; Yadav, Madhav P.; Roesch, Frank; Sheokand, Parvind; Satapathy, Swayamjeet; Tripathi, Madhavi; Agarwal, Shipra; Moon, Euy Sung; Bal, Chandrasekhar

doi:10.3390/ph17030275

Open AccessArticle

Head-to-Head Comparison of SSTR Antagonist [⁶⁸Ga]Ga-DATA^5m-LM4 with SSTR Agonist [⁶⁸Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study

by

Rahul Viswanathan

^1,†

,

Sanjana Ballal

^1,†,

Madhav P. Yadav

¹,

Frank Roesch

^2,*,

Parvind Sheokand

¹

,

Swayamjeet Satapathy

¹,

Madhavi Tripathi

¹,

Shipra Agarwal

³

,

Euy Sung Moon

² and

Chandrasekhar Bal

^1,*

¹

Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029, India

²

Department of Chemistry—TRIGA Site, Johannes Gutenberg University, 55128 Mainz, Germany

³

Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India

^*

Authors to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

Pharmaceuticals 2024, 17(3), 275; https://doi.org/10.3390/ph17030275

Submission received: 7 January 2024 / Revised: 18 February 2024 / Accepted: 19 February 2024 / Published: 22 February 2024

(This article belongs to the Special Issue Development of Novel Radiotracers for PET Imaging)

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Abstract

Neuroendocrine tumors (NETs) are slow-growing tumors that express high levels of somatostatin receptors (SSTRs). Recent studies have shown the superiority of radiolabeled SSTR antagonists in theranostics compared to agonists. In this prospective study, we compared the diagnostic efficacy between [⁶⁸Ga]Ga-DOTANOC and [⁶⁸Ga]Ga-DATA^5m-LM4 in the detection of primary and metastatic lesions in patients with well differentiated gastroenteropancreatic (GEP) NETs. Histologically proven GEP-NET patients underwent [⁶⁸Ga]Ga-DOTANOC & [⁶⁸Ga]Ga-DATA^5m-LM4 PET/CT scans, which were analyzed. The qualitative analysis involved the visual judgment of radiotracer uptake validated by the morphological findings using CT, which was considered as the reference standard. Quantitative comparisons were presented as the standardized uptake value (SUV) corrected for lean body mass: SULpeak, SULavg, and tumor-to-background ratios (TBR). In total, 490 lesions were confirmed via diagnostic CT. The lesion-based sensitivity of [⁶⁸Ga]Ga-DATA^5m-LM4 PET/CT was 94.28% (462/490) and 83.46% (409/490) for [⁶⁸Ga]Ga-DOTANOC PET/CT (p < 0.0001). [⁶⁸Ga]Ga-DATA^5m-LM4 had statistical significance over [⁶⁸Ga]Ga-DOTANOC in liver metastases [100% vs. 89.4%; p < 0.0001 (292 vs. 253 {283 lesions on CT})] and bone metastases [100% vs. 82.9%; p = 0.005 (45 vs. 34 {41 lesions on CT})]. Statistical significance was also noted for the TBR SULpeak of the primary and liver lesions. [⁶⁸Ga]Ga-DATA^5m-LM4 showed better sensitivity and a higher target-to-background ratio than [⁶⁸Ga]Ga-DOTANOC PET/CT. [⁶⁸Ga]Ga-DATA^5m-LM4 PET/CT can be used to quantify the extent of skeletal and liver metastases for better planning of SSTR agonist- or antagonist-based therapy.

Keywords: neuroendocrine tumors; NETs; [⁶⁸Ga]Ga-DATA^5m-LM4; [⁶⁸Ga]Ga-DOTANOC; PET/CT; SSTR antagonist

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MDPI and ACS Style

Viswanathan, R.; Ballal, S.; Yadav, M.P.; Roesch, F.; Sheokand, P.; Satapathy, S.; Tripathi, M.; Agarwal, S.; Moon, E.S.; Bal, C. Head-to-Head Comparison of SSTR Antagonist [⁶⁸Ga]Ga-DATA^5m-LM4 with SSTR Agonist [⁶⁸Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study. Pharmaceuticals 2024, 17, 275. https://doi.org/10.3390/ph17030275

AMA Style

Viswanathan R, Ballal S, Yadav MP, Roesch F, Sheokand P, Satapathy S, Tripathi M, Agarwal S, Moon ES, Bal C. Head-to-Head Comparison of SSTR Antagonist [⁶⁸Ga]Ga-DATA^5m-LM4 with SSTR Agonist [⁶⁸Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study. Pharmaceuticals. 2024; 17(3):275. https://doi.org/10.3390/ph17030275

Chicago/Turabian Style

Viswanathan, Rahul, Sanjana Ballal, Madhav P. Yadav, Frank Roesch, Parvind Sheokand, Swayamjeet Satapathy, Madhavi Tripathi, Shipra Agarwal, Euy Sung Moon, and Chandrasekhar Bal. 2024. "Head-to-Head Comparison of SSTR Antagonist [⁶⁸Ga]Ga-DATA^5m-LM4 with SSTR Agonist [⁶⁸Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study" Pharmaceuticals 17, no. 3: 275. https://doi.org/10.3390/ph17030275

APA Style

Viswanathan, R., Ballal, S., Yadav, M. P., Roesch, F., Sheokand, P., Satapathy, S., Tripathi, M., Agarwal, S., Moon, E. S., & Bal, C. (2024). Head-to-Head Comparison of SSTR Antagonist [⁶⁸Ga]Ga-DATA^5m-LM4 with SSTR Agonist [⁶⁸Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study. Pharmaceuticals, 17(3), 275. https://doi.org/10.3390/ph17030275

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Head-to-Head Comparison of SSTR Antagonist [⁶⁸Ga]Ga-DATA^5m-LM4 with SSTR Agonist [⁶⁸Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study

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