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Comparison of the prognostic values of 68Ga-DOTANOC PET/CT and 18F-FDG PET/CT in patients with well-differentiated neuroendocrine tumor

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To determine the prognostic value of 68Ga-DOTANOC PET/CT in patients with well-differentiated neuroendocrine tumor (NET), and to compare the prognostic value with that of 18F-FDG PET/CT and other conventional clinicopathological prognostic factors.

Methods

Data from 37 consecutive patients (age 46.6 ± 13.5 years, 51 % men) with well-differentiated NET who underwent 68Ga-DOTANOC PET/CT and 18F-FDG PET/CT were analyzed. All patients underwent a baseline visit with laboratory and radiological examinations. Clinical and imaging follow-up was performed in all patients. Progression-free survival (PFS) was measured from the date of the first PET/CT scan to the first documentation of progression of disease.

Results

68Ga-DOTANOC PET/CT was positive in 37 of the 37 patients and 18F-FDG PET/CT was positive in 21. During follow-up 10 patients (27 %) showed progression of disease and 27 (73 %) showed no progression (24 stable disease, 3 partial response). The median follow-up was 25 months (range 2 – 52 months). Among the variables evaluated none was significantly different between the progressive disease and nonprogressive disease groups, with only SUVmax on 68Ga-DOTANOC PET/CT being borderline significant (P = 0.073). In the univariate analysis for PFS outcome, SUVmax on 68Ga-DOTANOC PET/CT (HR 0.122, 95 % CI 0.019 – 0.779; P = 0.026) and histopathological tumor grade (HR 4.238, 95 % CI 1.058 – 16.976; P = 0.041) were found to be associated with PFS. Other factors including age, sex, primary site, Ki-67 index, TNM stage, 18F-FDG PET/CT status (positive/negative), SUVmax on 18F-FDG PET/CT and type of treatment were not significant. In multivariable analysis, only SUVmax on 68Ga-DOTANOC PET/CT was found to be an independent positive predictor of PFS (HR 0.122, 95 % CI 0.019 – 0.779; P = 0.026).

Conclusion

SUVmax measured on 68Ga-DOTANOC PET/CT is an independent, positive prognostic factor in patients with well-differentiated NET and is superior to SUVmax on 18F-FDG PET/CT and conventional clinicopathological factors for predicting PFS.

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Authors and Affiliations

  1. Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

    Punit Sharma, Niraj Naswa, Sudhir Suman KC, Yashwant Yadav, Rakesh Kumar & Chandrasekhar Bal

  2. Division of Biostatistics and Epidemiology, Texas Tech University Health Sciences Center, El Paso, TX, USA

    Luis Andres Alvarado & Alok Kumar Dwivedi

  3. Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India

    Ariachery C. Ammini

Authors
  1. Punit Sharma
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  2. Niraj Naswa
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  9. Chandrasekhar Bal
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Correspondence to Chandrasekhar Bal.

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No funding was received from any organization for this study.

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Sharma, P., Naswa, N., KC, S.S. et al. Comparison of the prognostic values of 68Ga-DOTANOC PET/CT and 18F-FDG PET/CT in patients with well-differentiated neuroendocrine tumor. Eur J Nucl Med Mol Imaging 41, 2194–2202 (2014). https://doi.org/10.1007/s00259-014-2850-3

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  • DOI: https://doi.org/10.1007/s00259-014-2850-3

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