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Molecular response assessed by 68Ga-DOTANOC and survival after 90Y microsphere therapy in patients with liver metastases from neuroendocrine tumours

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Abstract

Purpose

We investigated the prognostic role of 68Ga-DOTANOC in patients affected by hepatic metastases from neuroendocrine tumours (NET) undergoing 90Y radioembolization (90Y-RE).

Methods

A group of 15 consecutive patients with unresectable NET liver metastases underwent 68Ga-DOTANOC PET at baseline and 6 weeks after 90Y-RE. Molecular response was defined as a reduction of >50 % in the tumour-to-spleen ratio (ΔT/S). The patients were divided into two groups (responders with ΔT/S >50 % and nonresponders with ΔT/S <50 %) Patients were followed up by imaging and laboratory tests every 3 months until death or for at least 36 months following 90Y-RE. Statistical analysis was performed to identify factors predicting overall survival (OS) and progression-free survival (PFS).

Results

A decrease in T/S ratio was seen in all patients on 68Ga-DOTANOC PET scans performed after 90Y-RE. Nine patients were classified as responders and six as nonresponders. The mean OS in all patients was 31.0 months. Responders had a significantly (p < 0.001) longer OS (mean 36.0 ± 2.5 months) and PFS (mean 29.7 ± 3.4 months) than nonresponders. In a multivariate analysis, none of the other examined variables including age, unilobar vs. bilobar locations, bilirubin levels, radiological response or the presence of extrahepatic disease significantly predicted patient outcome.

Conclusion

Molecular response assessed with 68Ga-DOTANOC PET might be a useful predictor of survival in patients affected by NET liver metastases treated with 90Y-RE.

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Compliance with ethical standards

Funding

None.

Conflicts of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Santa Maria Goretti Hospital, Via Canova 3, 04100, Latina, Italy

    Luca Filippi, Rita Salvatori & Oreste Bagni

  2. Department of Nuclear Medicine, Sant’Andrea Hospital, via di Grottarossa 1035/1039, 00189, Rome, Italy

    Francesco Scopinaro

  3. Department of Interventional Radiology, Santa Maria Goretti Hospital, Via Canova 3, 04100, Latina, Italy

    Giuseppe Pelle & Roberto Cianni

  4. Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy

    Orazio Schillaci

Authors
  1. Luca Filippi
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  2. Francesco Scopinaro
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  3. Giuseppe Pelle
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  4. Roberto Cianni
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  7. Oreste Bagni
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Correspondence to Luca Filippi.

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Filippi, L., Scopinaro, F., Pelle, G. et al. Molecular response assessed by 68Ga-DOTANOC and survival after 90Y microsphere therapy in patients with liver metastases from neuroendocrine tumours. Eur J Nucl Med Mol Imaging 43, 432–440 (2016). https://doi.org/10.1007/s00259-015-3178-3

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  • DOI: https://doi.org/10.1007/s00259-015-3178-3

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