Role of 68Ga-DOTATOC PET/CT in initial evaluation of patients with suspected bronchopulmonary carcinoid

• Published in: European journal of nuclear medicine and molecular imaging 2014-05, Vol.41 (5), p.856-864
• Main Authors: Venkitaraman, Balasubramanian, Karunanithi, Sellam, Kumar, Arvind, Khilnani, G. C., Kumar, Rakesh
• Format: Article
• Language: English
• Subjects: Adult; Aged; Carcinoid Tumor - diagnostic imaging; Cardiology; Female; Fluorodeoxyglucose F18; Humans; Imaging; Lung Neoplasms - diagnostic imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Multimodal Imaging; Nuclear Medicine; Octreotide - analogs & derivatives; Oncology; Organometallic Compounds; Original Article; Orthopedics; Positron-Emission Tomography; Radiology; Radiopharmaceuticals; Tomography, X-Ray Computed
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-013-2659-5

Purpose The objective of this study was to evaluate the role of 68 Ga-DOTATOC positron emission tomography (PET)/CT scan in patients with suspected pulmonary carcinoid tumour and to compare its results with 18 F-fluorodeoxyglucose (FDG) PET/CT scan. Methods In this prospective study, 32 patients (age 34.22 ± 12.03 years; 53.1 % female) with clinical suspicion of bronchopulmonary carcinoid were evaluated with 68 Ga-DOTATOC PET/CT and 18 F-FDG PET/CT. The two imaging modalities were compared, considering the tissue diagnosis as the reference standard. Results Based on the reference standard 26 cases were carcinoid tumours [21 typical carcinoids (TC) and 5 atypical carcinoids (AC)] and 6 cases were non-carcinoid tumours. The sensitivity, specificity and accuracy of 68 Ga-DOTATOC PET/CT in the diagnosis of pulmonary carcinoid tumour were 96.15, 100 and 96.87 % respectively, whereas those of 18 F-FDG PET/CT were 78.26, 11.1 and 59.37 % respectively. The maximum standardised uptake value (SUV max ) of TC on 68 Ga-DOTATOC PET/CT scan ranged from 3.58 to 55, while that of AC ranged from 1.1 to 32.5. 18 F-FDG PET/CT was true-positive in all cases of AC and false-negative in eight cases of TC (sensitivity for TC 61.9 % and for AC 100 %). Conclusion 68 Ga-DOTATOC PET/CT is a useful imaging investigation for the evaluation of pulmonary carcinoids. 18 F-FDG PET/CT scan suffers from low sensitivity and specificity in differentiating the pulmonary carcinoids from other tumours.