Prospective Multicentric Assessment of 68Ga-DOTANOC PET/CT in Grade 1-2 GEP-NET
by
, ,
Alexandre Lugat
1,2,3
,
Éric Frampas
2,4,
Yann Touchefeu
2,5,
Éric Mirallié
6,
Maëlle Le Bras
7,
Hélène Senellart
8,
Aurore Rauscher
9,
Vincent Fleury
10,
Loïc Campion
2,11
,
Vincent Rohmer
12,
Olivier-François Couturier
13,
Rachida Lebtahi
14,
François Rouzet
15,16,
Philippe Ruszniewski
17,18,
Françoise Kraeber-Bodéré
2,3,
Mickaël Bourgeois
2,3,19 and
Catherine Ansquer
2,3,* 1
Medical Oncology Department, CHU Nantes, 44000 Nantes, France
2
Center for Research in Cancerology and Immunology Nantes-Angers (CRCINA), University of Nantes, INSERM UMR 1232, 44000 Nantes, France
3
CHU Nantes, Nantes Université, Médecine Nucléaire, 44000 Nantes, France
4
Central Department of Radiology and Medical Imaging, CHU Nantes, 44000 Nantes, France
5
The Enteric Nervous System in Gut and Brain Disorders, Université de Nantes, INSERM, TENS, IMAD, 44000 Nantes, France
6
Chirurgie Cancérologique, Digestive et Endocrinienne, Institut des Maladies de l’Appareil Digestif, CHU de Nantes, 44000 Nantes, France
7
Department of Endocrinology, Diabetology and Nutrition, L’institut du Thorax, CHU Nantes, 44000 Nantes, France
8
Department of Medical Oncology, ICO Cancer Center, 44000 Nantes, France
9
Pharmacy, ICO Cancer Center, 44000 Nantes, France
10
Department of Nuclear Medicine, ICO Cancer Center, 44000 Nantes, France
11
Biometrics, ICO Cancer Center, 44000 Nantes, France
12
Endocrinology Department, University Hospital, 49100 Angers, France
13
Nuclear Medicine Department, University Hospital, 49100 Angers, France
14
Department of Nuclear Medicine, Beaujon Hospital, 92110, Clichy, France
15
Nuclear Medicine Department, Hôpital Bichat-Claude Bernard, AP-HP, 75018 Paris, France
16
Université de Paris and Inserm U1148, 75018 Paris, France
17
Université de Paris, Department of Gastroenterology-Pancreatology, ENETS Centre of Excellence, Beaujon University Hospital (APHP), 92110 Clichy, France
18
Université de Paris, Centre of Research on Inflammation, INSERM U1149, 75018 Paris, France
19
Groupement d’Intérêt Public Arronax, 44800 Saint-Herblain, France
*
Author to whom correspondence should be addressed.
Cancers 2023, 15(2), 513; https://doi.org/10.3390/cancers15020513
Submission received: 4 December 2022
/
Revised: 11 January 2023
/
Accepted: 12 January 2023
/
Published: 14 January 2023
(This article belongs to the Special Issue Diagnosis and Treatment of Gastroenteropancreatic Neuroendocrine Neoplasms)
Simple Summary
Determining the most sensitive imaging technique to evaluate neuroendocrine tumors spread may have an impact on therapeutic management. The aim of this multicentric study was to prospectively assess 68Ga-DOTANOC PET/CT sensitivity compared to the combination of multiphasic CT, somatostatin receptor scintigraphy and MRI to evaluate whether this imaging modality results in therapeutic modifications. We confirm in a homogenous population of 105 grade 1 or 2 gastroenteropancreatic neuroendocrine tumors the higher sensitivity of 68Ga-DOTANOC PET/CT in per-patient and per-region analysis, as well as in the detection of primary tumor and small lesions such as peritoneal carcinomatosis and bone lesions leading to an impact on therapeutic management of almost half of the patients.
Abstract
The aim of this multicentric study was to prospectively compare 68Ga-DOTANOC PET/CT versus somatostatin receptor scintigraphy (SRS) with SPECT/CT, combined with multiphasic CT scan and MRI in patients with grade 1 or 2 gastroenteropancreatic neuroendocrine tumors (GEP-NET). Patients with histologically proven grade 1 or 2 GEP-NET with suspicion of recurrence or progression, or with typical aspects of GEP-NET on morphological imaging, were explored with conventional imaging (CI): SRS with SPECT/CT, multiphasic CT scan and/or liver MRI followed by 68Ga-DOTANOC PET/CT. The gold standard was based on histology and imaging follow-up. The data of 105 patients (45 woman and 60 men; median age) were analyzed. 68Ga-DOTANOC PET/CT sensitivity was significantly higher than CI sensitivity in per-patient (98.9% vs. 88.6%, p = 0.016) and per-region (97.6% vs. 75.6%, p < 0.001) analyses, in the detection of the primary (97.9% vs. 78.7%; p = 0.016), peritoneal carcinomatosis (95% vs. 30%, p < 0.001), and bone metastases (100% vs. 33.3%, p = 0.041). 68Ga-DOTANOC PET/CT had an impact on the therapeutic management of 41.9% (44/105) patients compared to decisions based on CI explorations. Our data confirm the superiority of 68Ga-DOTANOC PET/CT over CI in the detection of peritoneal carcinomatosis and bone metastasis, as well as its strong therapeutic impact on the management of patients with grade 1-2 GEP-NETs.
