Breath-hold [68Ga]DOTA-TOC PET/CT in neuroendocrine tumors: detection of additional lesions and effects on quantitative parameters.

Abstract

BACKGROUND:

Respiratory motion during PET/CT acquisition generates artifacts in the form of breath-related blurring, which influences the lesion detectability and diagnostic accuracy. The goal of this study was to verify whether breath-hold [68Ga]DOTA-TOC PET/CT (bhPET) allows detection of additional foci compared to free-breathing PET/CT (fbPET), and to assess the impact of breath-holding on standard uptake values (SUV) and isocontoured volume (Vic40) in patients with neuroendocrine tumors (NET).

METHODS:

Patients with NET (N.=39) were included in this study. BhPET and fbPET characteristics of 96 lesions were compared, and correlated with standard contrast-enhanced (ce) CT and MRI for lesion verification. Quantitative parameters SUV (max and mean) and Vic40 were assessed for both methods and evaluated by linear regression and Spearman's correlation. The impact of lesion size, localization and time interval between investigations was also analyzed.

RESULTS:

bhPET identified one additional metastasis not seen at fbPET but visible at ceMRI. Another additional bhPET focus did not have a morphological correlate. At bhPET, the SUVmax and SUVmean proved significantly higher and the Vic40 significantly lower than at fbPET. Lesion size, localization and time intervals did not impact significantly on SUV or Vic40.

CONCLUSIONS:

Currently, routine use of breath-hold [68Ga]DOTA-TOC PET/CT cannot be recommended as only one additional lesion was identified. Therefore, bhPET has currently no indication in patients with NET. If technical improvements regarding PET/CT scanner sensitivity are available, bhPET should be reevaluated in the future.

• Authors: Mariana Zirnsak, Robert Bärwolf, Martin Freesmeyer
• Journal: The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of... (Q J Nucl Med Mol Imaging) Vol. 63 Issue 3 Pg. 292-301 (Sep 2019) ISSN: 1827-1936 [Electronic] Italy
• PMID: 27824238 (Publication Type: Journal Article)

Chemical References

• Organometallic Compounds
• gallium Ga 68 dotatate

Topics

• Adult
• Aged
• Aged, 80 and over
• Breath Holding
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Metastasis
• Neuroendocrine Tumors (diagnostic imaging, pathology, physiopathology)
• Organometallic Compounds
• Positron Emission Tomography Computed Tomography (methods)