Impact of Ga-68 DOTATOC PET/CT on the diagnosis and treatment of patients with multiple endocrine neoplasia

Riferimento: 
Ann Nucl Med. 2012 Nov;26(9):738-43.
Autori: 
Froeling V, Elgeti F, Maurer MH, Scheurig-Muenkler C, Beck A, Kroencke TJ, Pape UF, Hamm B, Brenner W, Schreiter NF.
Fonte: 
Ann Nucl Med. 2012 Nov;26(9):738-43.
Anno: 
2012
Azione: 
68Ga DOTATOC PET/TC sono state positivamente valutate sulla diagnosi e gestione terapeutica dei pazienti con neoplasia endocrina multipla (MEN).
Target: 
8Ga DOTATOC PET-TC/neoplasia endocrina multipla.

ABSTRACT
PURPOSE:
To evaluate the impact of Ga-68 DOTATOC PET/CT on diagnosis and therapeutic management of patients with multiple endocrine neoplasia (MEN).
MATERIALS AND METHODS:
We did 28 Ga-68 DOTATOC PET/CT in 21 MEN patients (10 female, 11 men; mean age 41.3 years). 109 lesions detected were classified into MEN-associated lesions [i.e., neuroendocrine tumors (NET)] and non-MEN-associated lesions for PET, CT, and PET/CT. The impact of Ga-68 DOTATOC PET/CT on diagnosis and therapeutic management of patients with MEN were assessed by the records of the interdisciplinary NET tumor board including histopathological findings, clinical and radiological follow-up.
RESULTS:
Ga-68 DOTATOC PET/CT had an impact on diagnosis and therapeutic management in 10/21 (47.6%) MEN patients. For detecting NET lesions in MEN patients Ga-68 DOTATOC PET/CT reached a sensitivity/specificity of 91.7%/93.5%. There was a significant difference for the detection rate between Ga-68 DOTATOC PET/CT and CT alone (p < 0.001) both using contrast-agent (p = 0.002) or not (p < 0.001) and also a significant difference between contrast-enhanced (CE-) CT and non-CE-CT alone (p = 0.006).
CONCLUSIONS:
GA-68 DOTATOC PET/CT allows a high detection rate of NET lesions in the context of MEN-1 syndrome as well as influence therapeutic management in nearly up to half of the patients. GA-68 DOTATOC PET/CT should include a CE-CT to improve MEN-associated NET lesion detection.