Nöroendokrin Tümör ?üphesi Olan Hastalarda Ga-68 DOTATATE Pozitron Emisyon Tomografisi/Bilgisayarl Tomografi Bulgular

Amaç: Nöroendokrin Tümör (NET) Lüphesi ile Ga-68 DOTATATE Pozitron Emisyon Tomografisi/Bilgisayarl Tomografi (PET/BT) görüntüleme yap lan hastalar n sonuçlar n retrospektif olarak de?erlendirmeyi ve NET saptanmas nda Ga68 DOTATATE PET/BT'nin yerini tan mlamay amaçlad k. Gereç ve Yöntem: Nöroendokrin tumor Lüphesi ile Ga-68 DOTATATE PET/BT yap lan 35 hastan n (26E; 9K, ort. yaL; 45.2±5.4) sonuçlar retrospektif olarak analiz edildi. Nöroendokrin tumor Lüphesi klinik bulgular (n:12), biyokimyasal parametrelerde yükselme (n:19) ve radyolojik bulgular (n:13) idi. Klinik/radyolojik takip ve/veya histopatolojik inceleme referans standart olarak kullan ld . Bulgular: Referans standart temel al narak 35 hastan n 13'ü NET olarak kabul edildi. Ga-68 DOTATATE PET/BT 13 hastan n 12'sinde pozitif ve 1'inde yalanc negative idi. En s k primer tümör lokalizayonu pankreas idi. Ga-68 DOTATATE PET/BT 12, 2, 20 and 1 hastada s ras ile Gerçek Pozitif (GP), Yalanc Pozitif (YP), Gerçek Negatif (GN) ve Yalanc Negatif (YN) idi. Ga-68 DOTATATE PET/BT için duyarl l k, özgüllük, pozitif pediatrig de?er, negatif pediatrik de?er ve do?ruluk s ras ile %85, %95, %92, %90 ve %91% olarak hesapland . Sonuç: Ga-68 DOTATATE PET/BT NET Lüphesinde tümör oda? n n saptanmas nda yüksek do?rulu?a sahiptir ve bu amaçla kullanlabilir.

Ga-68 DOTATATE Positron Emission Tomography Computed Tomography Findings in Patients with Neuroendocrine Tumor Suspicion

Aim: We aimed to retrospectively evaluate the outcome of patients with suspected neuroendocrine tumor (NET)s who underwent Ga-68 DOTATATE Pozitrun Emission Tomography/Computed Tomography (PET/CT) imaging and to describe the value of Ga-68 DOTATATE PET/CT in the detection of NETs. Material and Method: Ga-68 DOTATATE PET/CT images of 35 patients (26M; 9F, mean age; 45.2±5.4 years) with suspected NET were analyzed retrospectively. Suspicion of NET was due to clinical symptoms (n:12), elevated biochemical markers (n:19) and/or radiological findings (n:13). Clinical/imaging follow-up and/or histopathological confirmation was used as reference standard. Results: Based on the reference standard 13 of 35 patients had NET. Ga-68 DOTATATE PET/CT was positive in 12 out of 13 patients and it was false negative in 1 patient. Pancreas was the commonest site of the primary tumor. Ga-68 DOTATATE was TP(true pozitive), FP (False Positive), TN (True Negative) and FN (False Negative) in, 12, 2, 20 and 1, patients respectively. Sensitivity, specificity, Pozitive Pedictive Value (PPV), Negative Pedictive Value (NPV), and accuracy of Ga-68 DOTATATE PET/CT was calculated as 85%, 95%, 92%, 90% and 91%, respectively. Conclusion: Ga-68 DOTATATE PET/CT has a high accuracy in the detection of suspected NET. It can be used for searching possible NET in patients with suspicion.

___

  • 1. Kaltsas GA, Besser GM, Grossman AB. The diagnosis and medical management of advanced neuroendocrine tumors. Endocr Rev. 2004;25:458-511.
  • 2. Oberg K, Akerström G, Rindi G, Jelic S; ESMO Guidelines Working Group. Neuroendocrinegastroenteropancreatictu mours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.Ann Oncol. 2010 May;21Suppl 5: 223-7/227.
  • 3. Modlin IM, Gustafsson BI, Moss SF, et al. Chromogranin A--biological function and clinical utility in neuro endocrine tumor disease.Ann SurgOncol. 2010;17:2427-2443.
  • 4. Alexandraki KI, Kaltsas G. Gastroenteropancreatic neuroendocrine tumors: new insights in the diagnosis and therapy.Endocrine. 2012;41:40-52.
  • 5. Naswa N, Sharma P, Kumar A, et al. Gallium-68-DOTA-NOC PET/CT of patients with gastroenteropancreatic neuroendocrine tumors: a prospective single-center study.AJR Am J Roentgenol. 2011;197:1221-1228.
  • 6. Kowalski J, Henze M, Schuhmacher J, et al. Evaluation of positron emission tomography imaging using [68Ga]- DOTA-D Phe(1)-Tyr(3)-Octreotide in comparison to [111In]-DTPAOC SPECT. First results in patients with neuroendocrine tumors.Mol Imaging Biol. 2003;5:42-48.
  • 7. Gabriel M, Decristoforo C, Kendler D, et al. 68Ga-DOTA-Tyr3-octreotide PET in neuroendocrine tumors: comparison with somatostatin receptor scintigraphy and CT.J Nucl Med. 2007;48:508-518.
  • 8. Adams S, Baum R, Rink T, et al. Limited value of fluorine-18 fluorodeoxyglucose positron emission tomography for the imaging of neuroendocrine tumours.Eur J Nucl Med. 1998;25:79-83
  • 9. Ambrosini V, Campana D, Bodei L, et al. 68Ga-DOTANOC PET/CT clinical impact in patients with neuroendocrine tumors.J Nucl Med. 2010;51:669-673
  • 10. Buchmann I, Henze M, Engelbrecht S, et al. Comparison of 68Ga-DOTATOC PET and 111In-DTPAOC (Octreoscan) SPECT in patients with neuroendocrine tumours.Eur J Nucl Med Mol Imaging. 2007;34:1617-1626.
  • 11. Haug AR1, Cindea-Drimus R, Auernhammer CJ, et al. The role of 68Ga-DOTATATE PET/CT in suspected neuroendocrine tumors.J Nucl Med. 2012;53:1686-1692.
  • 12. Modlin IM, Gustafsson BI, Moss SF, et al. Chromogranin A--biological function and clinical utility in neuro endocrine tumor disease. Ann Surg Oncol. 2010;17:2427-2443.
  • 13. Spadaro A, Ajello A, Morace C, et al. Serum chromogranin-A in hepatocellular carcinoma: diagnostic utility and limits. World J Gastroenterol. 2005;11:1987- 1990.
  • 14. Malaguarnera M, Cristaldi E, Cammalleri L, et al. Elevated chromogranin A (CrA) serum levels in the patients with advanced pancreatic cancer. Arch Gerontol Geriatr. 2009;48:213-217.
  • 15. Sciola V, Massironi S, Conte D, et al. Plasma chromogranin a in patients with inflammatory bowel disease. Inflamm Bowel Dis. 2009;15:867-871.
  • 16. Larsen AI, Helle KB, Christensen M, et al. Effect of exercise training on chromogranin A and relationship to NANP and inflammatory cytokines in patients with chronic heart failure.Int J Cardiol. 2008;127:117-120.
  • 17. Zhu HX, Lou WH, Kuang TT, Wang DS.Post-splenectomy intrapancreatic accessory spleen mimicking endocrine tumor of the pancreas. Int J Surg Case Rep. 2014 15;5:1151-1153
  • 18. Collarino A1, Del Ciello A, Perotti G, Rufini V.Intrapancreatic Accessory Spleen Detected by 68Ga DOTANOC PET/CT and 99m Tc-Colloid SPECT/CT Scintigraphy. Clin Nucl Med. 2014 Sep 30.
  • 19. Kumar V, Boddeti DK.(68)Garadiopharmaceuticals for PET imaging of infection and inflammation. Recent Results Cancer Res. 2013;194:189-219.
  • 20. Virgolini I1, Traub-Weidinger T, Decristoforo C. Nuclear medicine in the detection and management of pancreatic islet-cell tumours. Best Pract Res Clin Endocrinol Metab. 2005;19:213-227.