Abstract | PURPOSE: To determine the prognostic value of (68)Ga-DOTANOC PET/CT in patients with well-differentiated neuroendocrine tumor (NET), and to compare the prognostic value with that of (18)F-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 (68)Ga-DOTANOC PET/CT and (18)F-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: (68)Ga-DOTANOC PET/CT was positive in 37 of the 37 patients and (18)F-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 (68)Ga-DOTANOC PET/CT being borderline significant (P = 0.073). In the univariate analysis for PFS outcome, SUVmax on (68)Ga-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, (18)F-FDG PET/CT status (positive/negative), SUVmax on (18)F-FDG PET/CT and type of treatment were not significant. In multivariable analysis, only SUVmax on (68)Ga-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 (68)Ga-DOTANOC PET/CT is an independent, positive prognostic factor in patients with well-differentiated NET and is superior to SUVmax on (18)F-FDG PET/CT and conventional clinicopathological factors for predicting PFS.
|
Authors | Punit Sharma, Niraj Naswa, Sudhir Suman Kc, Luis Andres Alvarado, Alok Kumar Dwivedi, Yashwant Yadav, Rakesh Kumar, Ariachery C Ammini, Chandrasekhar Bal |
Journal | European journal of nuclear medicine and molecular imaging
(Eur J Nucl Med Mol Imaging)
Vol. 41
Issue 12
Pg. 2194-202
(Dec 2014)
ISSN: 1619-7089 [Electronic] Germany |
PMID | 25030618
(Publication Type: Comparative Study, Journal Article)
|
Chemical References |
- 68Ga-DOTANOC
- Organometallic Compounds
- Radiopharmaceuticals
- Fluorodeoxyglucose F18
|
Topics |
- Adolescent
- Adult
- Aged
- Female
- Fluorodeoxyglucose F18
- Humans
- Male
- Middle Aged
- Multimodal Imaging
- Neuroendocrine Tumors
(diagnostic imaging)
- Organometallic Compounds
- Positron-Emission Tomography
- Predictive Value of Tests
- Radiopharmaceuticals
- Tomography, X-Ray Computed
|