Head-to-Head Comparison of SSTR Antagonist [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 with SSTR Agonist [<sup>68</sup>Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study
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 [&l...
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MDPI AG
2024-02-01
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| Online Access: | https://www.mdpi.com/1424-8247/17/3/275 |
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| author | Rahul Viswanathan Sanjana Ballal Madhav P. Yadav Frank Roesch Parvind Sheokand Swayamjeet Satapathy Madhavi Tripathi Shipra Agarwal Euy Sung Moon Chandrasekhar Bal |
| author_facet | Rahul Viswanathan Sanjana Ballal Madhav P. Yadav Frank Roesch Parvind Sheokand Swayamjeet Satapathy Madhavi Tripathi Shipra Agarwal Euy Sung Moon Chandrasekhar Bal |
| author_sort | Rahul Viswanathan |
| collection | DOAJ |
| description | 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 [<sup>68</sup>Ga]Ga-DOTANOC and [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 in the detection of primary and metastatic lesions in patients with well differentiated gastroenteropancreatic (GEP) NETs. Histologically proven GEP-NET patients underwent [<sup>68</sup>Ga]Ga-DOTANOC & [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-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 [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 PET/CT was 94.28% (462/490) and 83.46% (409/490) for [<sup>68</sup>Ga]Ga-DOTANOC PET/CT (<i>p</i> < 0.0001). [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 had statistical significance over [<sup>68</sup>Ga]Ga-DOTANOC in liver metastases [100% vs. 89.4%; <i>p</i> < 0.0001 (292 vs. 253 {283 lesions on CT})] and bone metastases [100% vs. 82.9%; <i>p</i> = 0.005 (45 vs. 34 {41 lesions on CT})]. Statistical significance was also noted for the TBR SULpeak of the primary and liver lesions. [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 showed better sensitivity and a higher target-to-background ratio than [<sup>68</sup>Ga]Ga-DOTANOC PET/CT. [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-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. |
| first_indexed | 2024-04-24T17:56:44Z |
| format | Article |
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| spelling | doaj.art-fa1451c9d0304faeacd69e299083da0f2024-03-27T13:59:10ZengMDPI AGPharmaceuticals1424-82472024-02-0117327510.3390/ph17030275Head-to-Head Comparison of SSTR Antagonist [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 with SSTR Agonist [<sup>68</sup>Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging StudyRahul Viswanathan0Sanjana Ballal1Madhav P. Yadav2Frank Roesch3Parvind Sheokand4Swayamjeet Satapathy5Madhavi Tripathi6Shipra Agarwal7Euy Sung Moon8Chandrasekhar Bal9Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Chemistry—TRIGA Site, Johannes Gutenberg University, 55128 Mainz, GermanyDepartment of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Pathology, All India Institute of Medical Sciences, New Delhi 110029, IndiaDepartment of Chemistry—TRIGA Site, Johannes Gutenberg University, 55128 Mainz, GermanyDepartment of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi 110029, IndiaNeuroendocrine 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 [<sup>68</sup>Ga]Ga-DOTANOC and [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 in the detection of primary and metastatic lesions in patients with well differentiated gastroenteropancreatic (GEP) NETs. Histologically proven GEP-NET patients underwent [<sup>68</sup>Ga]Ga-DOTANOC & [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-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 [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 PET/CT was 94.28% (462/490) and 83.46% (409/490) for [<sup>68</sup>Ga]Ga-DOTANOC PET/CT (<i>p</i> < 0.0001). [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 had statistical significance over [<sup>68</sup>Ga]Ga-DOTANOC in liver metastases [100% vs. 89.4%; <i>p</i> < 0.0001 (292 vs. 253 {283 lesions on CT})] and bone metastases [100% vs. 82.9%; <i>p</i> = 0.005 (45 vs. 34 {41 lesions on CT})]. Statistical significance was also noted for the TBR SULpeak of the primary and liver lesions. [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 showed better sensitivity and a higher target-to-background ratio than [<sup>68</sup>Ga]Ga-DOTANOC PET/CT. [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-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.https://www.mdpi.com/1424-8247/17/3/275neuroendocrine tumorsNETs[<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4[<sup>68</sup>Ga]Ga-DOTANOCPET/CTSSTR antagonist |
| spellingShingle | Rahul Viswanathan Sanjana Ballal Madhav P. Yadav Frank Roesch Parvind Sheokand Swayamjeet Satapathy Madhavi Tripathi Shipra Agarwal Euy Sung Moon Chandrasekhar Bal Head-to-Head Comparison of SSTR Antagonist [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 with SSTR Agonist [<sup>68</sup>Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study Pharmaceuticals neuroendocrine tumors NETs [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 [<sup>68</sup>Ga]Ga-DOTANOC PET/CT SSTR antagonist |
| title | Head-to-Head Comparison of SSTR Antagonist [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 with SSTR Agonist [<sup>68</sup>Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study |
| title_full | Head-to-Head Comparison of SSTR Antagonist [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 with SSTR Agonist [<sup>68</sup>Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study |
| title_fullStr | Head-to-Head Comparison of SSTR Antagonist [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 with SSTR Agonist [<sup>68</sup>Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study |
| title_full_unstemmed | Head-to-Head Comparison of SSTR Antagonist [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 with SSTR Agonist [<sup>68</sup>Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study |
| title_short | Head-to-Head Comparison of SSTR Antagonist [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 with SSTR Agonist [<sup>68</sup>Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study |
| title_sort | head to head comparison of sstr antagonist sup 68 sup ga ga data sup 5m sup lm4 with sstr agonist sup 68 sup ga ga dotanoc pet ct in patients with well differentiated gastroenteropancreatic neuroendocrine tumors a prospective imaging study |
| topic | neuroendocrine tumors NETs [<sup>68</sup>Ga]Ga-DATA<sup>5m</sup>-LM4 [<sup>68</sup>Ga]Ga-DOTANOC PET/CT SSTR antagonist |
| url | https://www.mdpi.com/1424-8247/17/3/275 |
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