Use of full-dose contrast-enhanced CT for extrahepatic staging using Gallium-68-DOTATATE PET/CT in patients with neuroendocrine tumors
PURPOSEStudies have demonstrated that positron emission tomography/computed tomography (PET/CT) with Gallium-68 (68Ga)-labeled somatostatin analogues are effective at detecting metastatic disease in neuroendocrine tumors (NET), especially extrahepatic metastases. However, PET in combination with ful...
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| Format: | Article |
| Language: | English |
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Galenos Publishing House
2021-07-01
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| Series: | Diagnostic and Interventional Radiology |
| Online Access: |
http://www.dirjournal.org/archives/archive-detail/article-preview/use-of-full-dose-contrast-enhanced-ct-for-extrahep/54308
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| _version_ | 1797691335824637952 |
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| author | Jonas Apitzsch Frederik Anton Verburg Felix Mottaghy Alexander Heinzel |
| author_facet | Jonas Apitzsch Frederik Anton Verburg Felix Mottaghy Alexander Heinzel |
| author_sort | Jonas Apitzsch |
| collection | DOAJ |
| description | PURPOSEStudies have demonstrated that positron emission tomography/computed tomography (PET/CT) with Gallium-68 (68Ga)-labeled somatostatin analogues are effective at detecting metastatic disease in neuroendocrine tumors (NET), especially extrahepatic metastases. However, PET in combination with full-dose contrast-enhanced CT (ceCT) exposes patients to higher radiation (~25 mSv). The use of non-contrast-enhanced low-dose CT (ldCT) can reduce radiation to about 10 mSv and may avoid contrast-induced side effects. This study seeks to determine whether ceCT could be omitted from NET assessments.METHODSWe retrospectively compared the performance of PET/ldCT versus PET/ceCT in 54 patients (26 male, 28 female) who had undergone a 68Ga-DOTATATE PET/CT. The selection criteria were as follows: available ldCT and ceCT, histologically confirmed NET, and follow-up of at least 6 months (median, 12.6 months; range, 6.1–23.2 months). The PET/ldCT and PET/ceCT images were analyzed separately. We reviewed metastases in the lungs, bones, and lymph nodes. The results were compared with the reference standard (clinical follow-up data).RESULTSThe PET/ceCT scans detected 139 true-positive bone lesions compared with 140 lesions detected by the PET/ldCT scans, 106 true-positive lymph node metastases (PET/ceCT) compared with 90 metastases detected by the PET/ldCT scans, and 26 true-positive lung lesions (PET/ceCT) compared with 6 lesions detected by the PET/ldCT scans. The overall lesion-based sensitivity for full-dose PET/ceCT was 97%, specificity 86%, negative predictive value (NPV) 93%, and positive predictive value (PPV) 93%. The overall lesion-based sensitivity for PET/ldCT was 85%, specificity 73%, NPV 72%, and PPV 85%.CONCLUSIONThis study presents the first evidence that ceCT should not be omitted from extrahepatic staging using 68Ga-DOTATATE PET/CT in patients with NET. ceCT alone can be used as a follow-up to reduce radiation exposure when the patient has already undergone PET/ceCT and suffers from non-DOTATATE-avid NET. |
| first_indexed | 2024-03-12T02:11:52Z |
| format | Article |
| id | doaj.art-17b2e5ea817a4b249c2bf63a0f96cf8e |
| institution | Directory Open Access Journal |
| issn | 1305-3825 1305-3612 |
| language | English |
| last_indexed | 2024-03-12T02:11:52Z |
| publishDate | 2021-07-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Diagnostic and Interventional Radiology |
| spelling | doaj.art-17b2e5ea817a4b249c2bf63a0f96cf8e2023-09-06T12:19:29ZengGalenos Publishing HouseDiagnostic and Interventional Radiology1305-38251305-36122021-07-0127457357910.5152/dir.2021.1942413049054Use of full-dose contrast-enhanced CT for extrahepatic staging using Gallium-68-DOTATATE PET/CT in patients with neuroendocrine tumorsJonas Apitzsch0Frederik Anton Verburg1Felix Mottaghy2Alexander Heinzel3 Department of Diagnostic and Interventional Radiology, Helios Hospital Pforzheim, Pforzheim, Germany Department of Nuclear Medicine, RWTH Aachen University Hospital, Aachen, Germany Department of Nuclear Medicine, RWTH Aachen University Hospital, Aachen, Germany Department of Nuclear Medicine, RWTH Aachen University Hospital, Aachen, Germany PURPOSEStudies have demonstrated that positron emission tomography/computed tomography (PET/CT) with Gallium-68 (68Ga)-labeled somatostatin analogues are effective at detecting metastatic disease in neuroendocrine tumors (NET), especially extrahepatic metastases. However, PET in combination with full-dose contrast-enhanced CT (ceCT) exposes patients to higher radiation (~25 mSv). The use of non-contrast-enhanced low-dose CT (ldCT) can reduce radiation to about 10 mSv and may avoid contrast-induced side effects. This study seeks to determine whether ceCT could be omitted from NET assessments.METHODSWe retrospectively compared the performance of PET/ldCT versus PET/ceCT in 54 patients (26 male, 28 female) who had undergone a 68Ga-DOTATATE PET/CT. The selection criteria were as follows: available ldCT and ceCT, histologically confirmed NET, and follow-up of at least 6 months (median, 12.6 months; range, 6.1–23.2 months). The PET/ldCT and PET/ceCT images were analyzed separately. We reviewed metastases in the lungs, bones, and lymph nodes. The results were compared with the reference standard (clinical follow-up data).RESULTSThe PET/ceCT scans detected 139 true-positive bone lesions compared with 140 lesions detected by the PET/ldCT scans, 106 true-positive lymph node metastases (PET/ceCT) compared with 90 metastases detected by the PET/ldCT scans, and 26 true-positive lung lesions (PET/ceCT) compared with 6 lesions detected by the PET/ldCT scans. The overall lesion-based sensitivity for full-dose PET/ceCT was 97%, specificity 86%, negative predictive value (NPV) 93%, and positive predictive value (PPV) 93%. The overall lesion-based sensitivity for PET/ldCT was 85%, specificity 73%, NPV 72%, and PPV 85%.CONCLUSIONThis study presents the first evidence that ceCT should not be omitted from extrahepatic staging using 68Ga-DOTATATE PET/CT in patients with NET. ceCT alone can be used as a follow-up to reduce radiation exposure when the patient has already undergone PET/ceCT and suffers from non-DOTATATE-avid NET. http://www.dirjournal.org/archives/archive-detail/article-preview/use-of-full-dose-contrast-enhanced-ct-for-extrahep/54308 |
| spellingShingle | Jonas Apitzsch Frederik Anton Verburg Felix Mottaghy Alexander Heinzel Use of full-dose contrast-enhanced CT for extrahepatic staging using Gallium-68-DOTATATE PET/CT in patients with neuroendocrine tumors Diagnostic and Interventional Radiology |
| title | Use of full-dose contrast-enhanced CT for extrahepatic staging using Gallium-68-DOTATATE PET/CT in patients with neuroendocrine tumors |
| title_full | Use of full-dose contrast-enhanced CT for extrahepatic staging using Gallium-68-DOTATATE PET/CT in patients with neuroendocrine tumors |
| title_fullStr | Use of full-dose contrast-enhanced CT for extrahepatic staging using Gallium-68-DOTATATE PET/CT in patients with neuroendocrine tumors |
| title_full_unstemmed | Use of full-dose contrast-enhanced CT for extrahepatic staging using Gallium-68-DOTATATE PET/CT in patients with neuroendocrine tumors |
| title_short | Use of full-dose contrast-enhanced CT for extrahepatic staging using Gallium-68-DOTATATE PET/CT in patients with neuroendocrine tumors |
| title_sort | use of full dose contrast enhanced ct for extrahepatic staging using gallium 68 dotatate pet ct in patients with neuroendocrine tumors |
| url |
http://www.dirjournal.org/archives/archive-detail/article-preview/use-of-full-dose-contrast-enhanced-ct-for-extrahep/54308
|
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