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Combined 68Ga-DOTA-peptides and 18F-FDG PET in the diagnostic work-up of neuroendocrine neoplasms (NEN)

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Abstract

Purpose

In patients with neuroendocrine neoplasm (NEN), the diagnostic role of positron-emission tomography (PET) using somatostatin receptor-targeted tracers, such as 68Ga-DOTATOC and 68Ga-DOTATATE in combination with 18F-FDG to assess glucose metabolism, is still a matter of debate. This systematic review aims to examine all published data on the role of combined 68Ga DOTA-peptides and 18F-FDG PET in the diagnosis and management of patients with NEN.

Methods

A systematic search of studies assessing the use of dual-tracer PET in patients with NEN has been carried out on PubMed, Web of Science and Scopus databases. PRISMA guidelines have been used to screen the suitable studies.

Results

Overall, 13 articles (658 patients in total) were considered for the analysis. All but three studies included patients with NEN of different primary sites of origin and different histologic grades. Seven studies included patients at initial diagnosis, whereas the remaining six considered patients at first diagnosis and at restaging after therapy. The median sensitivity of 68Ga DOTA-peptide PET (68Ga-DOTATOC, 68Ga-DOTATATE and 68Ga-DOTANOC) and 18F-FDG PET was 93% (range 82–100%) and 58% (range 37–75%), respectively. The median sensitivity of combined examinations was 94% (range 92–100%).

Conclusions

There is still very limited evidence supporting the role of a routine use of combined 68Ga DOTA-peptide and 18F-FDG PETs in the diagnostic work-up of NEN.

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Acknowledgements

PhD Scholarship of Dr. Valentina Andreasi and Research Fellowship of Dr. Francesca Muffatti were supported by Gioja Bianca Costanza Fund.

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Authors and Affiliations

  1. Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Vita-Salute University- IRCCS San Raffaele Hospital, Milan, Italy

    Francesca Muffatti, Stefano Partelli, Valentina Andreasi & Massimo Falconi

  2. Vita-Salute San Raffaele University, Milan, Italy

    Francesca Muffatti, Stefano Partelli, Valentina Andreasi, Paola Mapelli, Maria Picchio & Massimo Falconi

  3. Dipartimento di Scienze Chirurgiche e Biomediche, University of Perugia, Perugia, Italy

    Roberto Cirocchi

  4. Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Paola Mapelli, Maria Picchio & Luigi Gianolli

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  1. Francesca Muffatti
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  8. Massimo Falconi
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Contributions

FM: literature search, review, writing; SP: writing, statistical analysis; RC: literature search, review; VA: systematic review, analysis, writing; PM: systematic review, content planning; MP: editing, review; Luigi Gianolli: editing; MF: editing, final revision.

Corresponding author

Correspondence to Massimo Falconi.

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Muffatti, F., Partelli, S., Cirocchi, R. et al. Combined 68Ga-DOTA-peptides and 18F-FDG PET in the diagnostic work-up of neuroendocrine neoplasms (NEN). Clin Transl Imaging 7, 181–188 (2019). https://doi.org/10.1007/s40336-019-00328-1

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