Prognostic Value of 68Ga-DOTANOC PET/CT SUVmax in Patients with Neuroendocrine Tumors of the Pancreas.

Abstract

UNLABELLED:

This study was performed to investigate the role of (68)Ga-DOTANOC SUVmax as a potential prognostic factor in patients with pancreatic neuroendocrine tumor (pNET).

METHODS:

Among the patients who underwent (68)Ga-DOTANOC PET/CT, we retrospectively collected the data of those who had G1 or G2 pNET (2010 World Health Organization classification), presented with disease on PET/CT and CT, and had at least 6 mo of follow-up. Patients with multiple endocrine neoplasia were excluded.

RESULTS:

Overall, 43 patients were included. No significant differences in SUVmax were observed with respect to sex, tumor syndrome, stage, World Health Organization classification, or Ki-67. During follow-up (median, 20 mo), 11 patients (35.6%; median, 33 mo; interquartile range, 20-48 mo) had stable disease and 32 (74.4%; median, 19 mo; interquartile range, 14-26 mo) had progressive disease. SUVmax at 24 mo of follow-up was significantly higher (P = 0.022) in patients with stable disease than in patients with progressive disease. The best SUVmax cutoff ranged from 37.8 to 38.0. The major risk factors for progression included an SUVmax of no more than 37.8 (hazard ratio, 3.09; P = 0.003), a Ki-67 of more than 5% (hazard ratio, 2.89; P = 0.009), and medical therapy alone (hazard ratio, 2.36; P = 0.018). Advanced stage (IV) (P = 0.026), an SUVmax of less than 37.8 (P = 0.043), and medical therapy alone (P = 0.015) were also confirmed at multivariate analysis. Median progression-free survival was 23 mo. Significant differences in progression-free survival were observed in relationship to Ki-67 (median, 45 mo for Ki-67 ≤ 5% and 20 mo for Ki-67 > 5%; P = 0.005), SUVmax (<37.8 vs. >38.0: 16.0 vs. 27.0 mo; P = 0.002), and type of therapy (medical vs. peptide receptor radionuclide therapy: 16.0 vs. 26.0 mo; P = 0.014).

CONCLUSION:

(68)Ga-DOTANOC SUVmax is a relevant prognostic factor in patients with G1 and G2 pNET, and its routine use will improve disease characterization and management in these patients, who may present with atypical cases showing heterogeneous clinical behavior.

• Authors: Valentina Ambrosini, Davide Campana, Giulia Polverari, Chiara Peterle, Stefania Diodato, Claudio Ricci, Vincenzo Allegri, Riccardo Casadei, Paola Tomassetti, Stefano Fanti
• Journal: Journal of nuclear medicine : official publication, Society of Nuclear Medicine (J Nucl Med) Vol. 56 Issue 12 Pg. 1843-8 (Dec 2015) ISSN: 1535-5667 [Electronic] United States
• PMID: 26405169 (Publication Type: Journal Article)
• Copyright: © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Chemical References

• 68Ga-DOTANOC
• Ki-67 Antigen
• Organometallic Compounds
• Radiopharmaceuticals

Topics

• Adult
• Disease-Free Survival
• Female
• Follow-Up Studies
• Humans
• Ki-67 Antigen
• Male
• Middle Aged
• Neuroendocrine Tumors (diagnostic imaging, drug therapy, radiotherapy)
• Organometallic Compounds
• Pancreatic Neoplasms (diagnostic imaging, drug therapy, radiotherapy)
• Positron-Emission Tomography (methods)
• Predictive Value of Tests
• Prognosis
• Radiopharmaceuticals
• Retrospective Studies
• Risk Factors