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Comparison of sequential planar 177Lu-DOTA-TATE dosimetry scans with 68Ga-DOTA-TATE PET/CT images in patients with metastasized neuroendocrine tumours undergoing peptide receptor radionuclide therapy

Purpose The aim of the study was to compare sequential 177 Lu-DOTA-TATE planar scans ( 177 Lu-DOTA-TATE) in patients with metastasized neuroendocrine tumours (NET) acquired during peptide receptor radionuclide therapy (PRRT) for dosimetry purposes with the pre-therapeutic 68 Ga-DOTA-TATE positron em...

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Published in:European journal of nuclear medicine and molecular imaging 2012-03, Vol.39 (3), p.501-511
Main Authors: Sainz-Esteban, Aurora, Prasad, Vikas, Schuchardt, Christiane, Zachert, Carolin, Carril, José Manuel, Baum, Richard P.
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container_title European journal of nuclear medicine and molecular imaging
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Zachert, Carolin
Carril, José Manuel
Baum, Richard P.
description Purpose The aim of the study was to compare sequential 177 Lu-DOTA-TATE planar scans ( 177 Lu-DOTA-TATE) in patients with metastasized neuroendocrine tumours (NET) acquired during peptide receptor radionuclide therapy (PRRT) for dosimetry purposes with the pre-therapeutic 68 Ga-DOTA-TATE positron emission tomography (PET)/CT ( 68 Ga-DOTA-TATE) maximum intensity projection (MIP) images obtained in the same patients concerning the sensitivity of the different methods. Methods A total of 44 patients (59 ± 11 years old) with biopsy-proven NET underwent 68 Ga-DOTA-TATE and 177 Lu-DOTA-TATE imaging within 7.9 ± 7.5 days between the two examinations. 177 Lu-DOTA-TATE planar images were acquired at 0.5, 2, 24, 48 and 72 h post-injection; lesions were given a score from 0 to 4 depending on the uptake of the radiopharmaceutical (0 being lowest and 4 highest). The number of tumour lesions which were identified on 177 Lu-DOTA-TATE scans (in relation to the acquisition time after injection of the therapeutic dose as well as with regard to the body region) was compared to those detected on 68 Ga-DOTA-TATE studies obtained before PRRT. Results A total of 318 lesions were detected; 280 (88%) lesions were concordant. Among the discordant lesions, 29 were 68 Ga-DOTA-TATE positive and 177 Lu-DOTA-TATE negative, whereas 9 were 68 Ga-DOTA-TATE negative and 177 Lu-DOTA-TATE positive. The sensitivity, positive predictive value and accuracy for 177 Lu-DOTA-TATE as compared to 68 Ga-DOTA-TATE were 91, 97 and 88%, respectively. Significantly more lesions were seen on the delayed (72 h) 177 Lu-DOTA-TATE images (91%) as compared to the immediate (30 min) images (68%). The highest concordance was observed for bone metastases (97%) and the lowest for head/neck lesions (75%). Concordant lesions ( n  = 77; mean size 3.8 cm) were significantly larger than discordant lesions ( n  = 38; mean size 1.6 cm) ( p  
doi_str_mv 10.1007/s00259-011-2003-x
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Methods A total of 44 patients (59 ± 11 years old) with biopsy-proven NET underwent 68 Ga-DOTA-TATE and 177 Lu-DOTA-TATE imaging within 7.9 ± 7.5 days between the two examinations. 177 Lu-DOTA-TATE planar images were acquired at 0.5, 2, 24, 48 and 72 h post-injection; lesions were given a score from 0 to 4 depending on the uptake of the radiopharmaceutical (0 being lowest and 4 highest). The number of tumour lesions which were identified on 177 Lu-DOTA-TATE scans (in relation to the acquisition time after injection of the therapeutic dose as well as with regard to the body region) was compared to those detected on 68 Ga-DOTA-TATE studies obtained before PRRT. Results A total of 318 lesions were detected; 280 (88%) lesions were concordant. Among the discordant lesions, 29 were 68 Ga-DOTA-TATE positive and 177 Lu-DOTA-TATE negative, whereas 9 were 68 Ga-DOTA-TATE negative and 177 Lu-DOTA-TATE positive. The sensitivity, positive predictive value and accuracy for 177 Lu-DOTA-TATE as compared to 68 Ga-DOTA-TATE were 91, 97 and 88%, respectively. Significantly more lesions were seen on the delayed (72 h) 177 Lu-DOTA-TATE images (91%) as compared to the immediate (30 min) images (68%). The highest concordance was observed for bone metastases (97%) and the lowest for head/neck lesions (75%). Concordant lesions ( n  = 77; mean size 3.8 cm) were significantly larger than discordant lesions ( n  = 38; mean size 1.6 cm) ( p  &lt; 0.05). No such significance was found for differences in maximum standardized uptake value (SUV max ). However, concordant liver lesions with a score from 1 to 3 in the 72-h 177 Lu-DOTA-TATE scan had a lower SUV max ( n  = 23; mean 10.9) than those metastases with a score of 4 ( n  = 97; mean SUV max 18) ( p  &lt; 0.05). Conclusion Although 177 Lu-DOTA-TATE planar dosimetry scans exhibited a very good sensitivity for the detection of metastases, they failed to pick up 9% of lesions seen on the 68 Ga-DOTA-TATE PET/CT. Three-dimensional dosimetry using single photon emission computed tomography/CT could be applied to investigate this issue further. Delayed (72 h) images are most suitable for drawing regions of interest for dosimetric calculations.</description><identifier>ISSN: 1619-7070</identifier><identifier>EISSN: 1619-7089</identifier><identifier>DOI: 10.1007/s00259-011-2003-x</identifier><identifier>PMID: 22183108</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cardiology ; Female ; Humans ; Imaging ; Male ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Multimodal Imaging - methods ; Neoplasm Metastasis ; Neuroendocrine Tumors - diagnostic imaging ; Neuroendocrine Tumors - pathology ; Neuroendocrine Tumors - radiotherapy ; Nuclear Medicine ; Octreotide - analogs &amp; derivatives ; Oncology ; Organometallic Compounds ; Original Article ; Orthopedics ; Positron-Emission Tomography ; Radiology ; Radiometry ; Receptors, Peptide - therapeutic use ; Retrospective Studies ; Time Factors ; Tomography, X-Ray Computed ; Young Adult</subject><ispartof>European journal of nuclear medicine and molecular imaging, 2012-03, Vol.39 (3), p.501-511</ispartof><rights>Springer-Verlag 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c188x-c0d0d09cb0792fc8f4d2fc91d32e7c6f2f6370bc9c823287283aac8ccc7bcfd43</citedby><cites>FETCH-LOGICAL-c188x-c0d0d09cb0792fc8f4d2fc91d32e7c6f2f6370bc9c823287283aac8ccc7bcfd43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22183108$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sainz-Esteban, Aurora</creatorcontrib><creatorcontrib>Prasad, Vikas</creatorcontrib><creatorcontrib>Schuchardt, Christiane</creatorcontrib><creatorcontrib>Zachert, Carolin</creatorcontrib><creatorcontrib>Carril, José Manuel</creatorcontrib><creatorcontrib>Baum, Richard P.</creatorcontrib><title>Comparison of sequential planar 177Lu-DOTA-TATE dosimetry scans with 68Ga-DOTA-TATE PET/CT images in patients with metastasized neuroendocrine tumours undergoing peptide receptor radionuclide therapy</title><title>European journal of nuclear medicine and molecular imaging</title><addtitle>Eur J Nucl Med Mol Imaging</addtitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><description>Purpose The aim of the study was to compare sequential 177 Lu-DOTA-TATE planar scans ( 177 Lu-DOTA-TATE) in patients with metastasized neuroendocrine tumours (NET) acquired during peptide receptor radionuclide therapy (PRRT) for dosimetry purposes with the pre-therapeutic 68 Ga-DOTA-TATE positron emission tomography (PET)/CT ( 68 Ga-DOTA-TATE) maximum intensity projection (MIP) images obtained in the same patients concerning the sensitivity of the different methods. Methods A total of 44 patients (59 ± 11 years old) with biopsy-proven NET underwent 68 Ga-DOTA-TATE and 177 Lu-DOTA-TATE imaging within 7.9 ± 7.5 days between the two examinations. 177 Lu-DOTA-TATE planar images were acquired at 0.5, 2, 24, 48 and 72 h post-injection; lesions were given a score from 0 to 4 depending on the uptake of the radiopharmaceutical (0 being lowest and 4 highest). The number of tumour lesions which were identified on 177 Lu-DOTA-TATE scans (in relation to the acquisition time after injection of the therapeutic dose as well as with regard to the body region) was compared to those detected on 68 Ga-DOTA-TATE studies obtained before PRRT. Results A total of 318 lesions were detected; 280 (88%) lesions were concordant. Among the discordant lesions, 29 were 68 Ga-DOTA-TATE positive and 177 Lu-DOTA-TATE negative, whereas 9 were 68 Ga-DOTA-TATE negative and 177 Lu-DOTA-TATE positive. The sensitivity, positive predictive value and accuracy for 177 Lu-DOTA-TATE as compared to 68 Ga-DOTA-TATE were 91, 97 and 88%, respectively. Significantly more lesions were seen on the delayed (72 h) 177 Lu-DOTA-TATE images (91%) as compared to the immediate (30 min) images (68%). The highest concordance was observed for bone metastases (97%) and the lowest for head/neck lesions (75%). Concordant lesions ( n  = 77; mean size 3.8 cm) were significantly larger than discordant lesions ( n  = 38; mean size 1.6 cm) ( p  &lt; 0.05). No such significance was found for differences in maximum standardized uptake value (SUV max ). However, concordant liver lesions with a score from 1 to 3 in the 72-h 177 Lu-DOTA-TATE scan had a lower SUV max ( n  = 23; mean 10.9) than those metastases with a score of 4 ( n  = 97; mean SUV max 18) ( p  &lt; 0.05). Conclusion Although 177 Lu-DOTA-TATE planar dosimetry scans exhibited a very good sensitivity for the detection of metastases, they failed to pick up 9% of lesions seen on the 68 Ga-DOTA-TATE PET/CT. Three-dimensional dosimetry using single photon emission computed tomography/CT could be applied to investigate this issue further. Delayed (72 h) images are most suitable for drawing regions of interest for dosimetric calculations.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiology</subject><subject>Female</subject><subject>Humans</subject><subject>Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Multimodal Imaging - methods</subject><subject>Neoplasm Metastasis</subject><subject>Neuroendocrine Tumors - diagnostic imaging</subject><subject>Neuroendocrine Tumors - pathology</subject><subject>Neuroendocrine Tumors - radiotherapy</subject><subject>Nuclear Medicine</subject><subject>Octreotide - analogs &amp; derivatives</subject><subject>Oncology</subject><subject>Organometallic Compounds</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Positron-Emission Tomography</subject><subject>Radiology</subject><subject>Radiometry</subject><subject>Receptors, Peptide - therapeutic use</subject><subject>Retrospective Studies</subject><subject>Time Factors</subject><subject>Tomography, X-Ray Computed</subject><subject>Young Adult</subject><issn>1619-7070</issn><issn>1619-7089</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNp9kcFuEzEQhlcIREvhAbgg3ziZ2t4Q28cohIIUqRyWs-WMZ1NXu_Zir0XCC_JaOEqoOCFbmpH9zS_N_zfNW84-cMbkbWZMfNSUcU4FYy09PGuu-ZJrKpnSz596ya6aVzk_MsaVUPplcyUEVy1n6rr5vY7jZJPPMZDYk4w_CobZ24FMgw02ES7lttBP992KdqtuQ1zMfsQ5HUkGGzL56ecHslR39h_m26a7XXfEj3aPmfhAJjv7Knuh67jN9fpf6EjAkiIGFyH5gGQuYywpkxIcpn30YU8mnGbvkCSE2sVEknU-hgLD6XV-wGSn4-vmRW-HjG8u9ab5_nnTrb_Q7f3d1_VqS4ErdaDAXD0adkxq0YPqF64WzV0rUMKyF_2ylWwHGpRohZJCtdaCAgC5g94t2pvm_Vl3SrFalWcz-gw4VLMwlmy04HxR7W0ryc8kpJhzwt5MqTqSjoYzc4rPnOMzNT5zis8c6sy7i3rZjeieJv7mVQFxBnL9CntM5rHaFerG_1H9A66eqiI</recordid><startdate>201203</startdate><enddate>201203</enddate><creator>Sainz-Esteban, Aurora</creator><creator>Prasad, Vikas</creator><creator>Schuchardt, Christiane</creator><creator>Zachert, Carolin</creator><creator>Carril, José Manuel</creator><creator>Baum, Richard P.</creator><general>Springer-Verlag</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201203</creationdate><title>Comparison of sequential planar 177Lu-DOTA-TATE dosimetry scans with 68Ga-DOTA-TATE PET/CT images in patients with metastasized neuroendocrine tumours undergoing peptide receptor radionuclide therapy</title><author>Sainz-Esteban, Aurora ; Prasad, Vikas ; Schuchardt, Christiane ; Zachert, Carolin ; Carril, José Manuel ; Baum, Richard P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c188x-c0d0d09cb0792fc8f4d2fc91d32e7c6f2f6370bc9c823287283aac8ccc7bcfd43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiology</topic><topic>Female</topic><topic>Humans</topic><topic>Imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Middle Aged</topic><topic>Multimodal Imaging - methods</topic><topic>Neoplasm Metastasis</topic><topic>Neuroendocrine Tumors - diagnostic imaging</topic><topic>Neuroendocrine Tumors - pathology</topic><topic>Neuroendocrine Tumors - radiotherapy</topic><topic>Nuclear Medicine</topic><topic>Octreotide - analogs &amp; derivatives</topic><topic>Oncology</topic><topic>Organometallic Compounds</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Positron-Emission Tomography</topic><topic>Radiology</topic><topic>Radiometry</topic><topic>Receptors, Peptide - therapeutic use</topic><topic>Retrospective Studies</topic><topic>Time Factors</topic><topic>Tomography, X-Ray Computed</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sainz-Esteban, Aurora</creatorcontrib><creatorcontrib>Prasad, Vikas</creatorcontrib><creatorcontrib>Schuchardt, Christiane</creatorcontrib><creatorcontrib>Zachert, Carolin</creatorcontrib><creatorcontrib>Carril, José Manuel</creatorcontrib><creatorcontrib>Baum, Richard P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of nuclear medicine and molecular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sainz-Esteban, Aurora</au><au>Prasad, Vikas</au><au>Schuchardt, Christiane</au><au>Zachert, Carolin</au><au>Carril, José Manuel</au><au>Baum, Richard P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of sequential planar 177Lu-DOTA-TATE dosimetry scans with 68Ga-DOTA-TATE PET/CT images in patients with metastasized neuroendocrine tumours undergoing peptide receptor radionuclide therapy</atitle><jtitle>European journal of nuclear medicine and molecular imaging</jtitle><stitle>Eur J Nucl Med Mol Imaging</stitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><date>2012-03</date><risdate>2012</risdate><volume>39</volume><issue>3</issue><spage>501</spage><epage>511</epage><pages>501-511</pages><issn>1619-7070</issn><eissn>1619-7089</eissn><abstract>Purpose The aim of the study was to compare sequential 177 Lu-DOTA-TATE planar scans ( 177 Lu-DOTA-TATE) in patients with metastasized neuroendocrine tumours (NET) acquired during peptide receptor radionuclide therapy (PRRT) for dosimetry purposes with the pre-therapeutic 68 Ga-DOTA-TATE positron emission tomography (PET)/CT ( 68 Ga-DOTA-TATE) maximum intensity projection (MIP) images obtained in the same patients concerning the sensitivity of the different methods. Methods A total of 44 patients (59 ± 11 years old) with biopsy-proven NET underwent 68 Ga-DOTA-TATE and 177 Lu-DOTA-TATE imaging within 7.9 ± 7.5 days between the two examinations. 177 Lu-DOTA-TATE planar images were acquired at 0.5, 2, 24, 48 and 72 h post-injection; lesions were given a score from 0 to 4 depending on the uptake of the radiopharmaceutical (0 being lowest and 4 highest). The number of tumour lesions which were identified on 177 Lu-DOTA-TATE scans (in relation to the acquisition time after injection of the therapeutic dose as well as with regard to the body region) was compared to those detected on 68 Ga-DOTA-TATE studies obtained before PRRT. Results A total of 318 lesions were detected; 280 (88%) lesions were concordant. Among the discordant lesions, 29 were 68 Ga-DOTA-TATE positive and 177 Lu-DOTA-TATE negative, whereas 9 were 68 Ga-DOTA-TATE negative and 177 Lu-DOTA-TATE positive. The sensitivity, positive predictive value and accuracy for 177 Lu-DOTA-TATE as compared to 68 Ga-DOTA-TATE were 91, 97 and 88%, respectively. Significantly more lesions were seen on the delayed (72 h) 177 Lu-DOTA-TATE images (91%) as compared to the immediate (30 min) images (68%). The highest concordance was observed for bone metastases (97%) and the lowest for head/neck lesions (75%). Concordant lesions ( n  = 77; mean size 3.8 cm) were significantly larger than discordant lesions ( n  = 38; mean size 1.6 cm) ( p  &lt; 0.05). No such significance was found for differences in maximum standardized uptake value (SUV max ). However, concordant liver lesions with a score from 1 to 3 in the 72-h 177 Lu-DOTA-TATE scan had a lower SUV max ( n  = 23; mean 10.9) than those metastases with a score of 4 ( n  = 97; mean SUV max 18) ( p  &lt; 0.05). Conclusion Although 177 Lu-DOTA-TATE planar dosimetry scans exhibited a very good sensitivity for the detection of metastases, they failed to pick up 9% of lesions seen on the 68 Ga-DOTA-TATE PET/CT. Three-dimensional dosimetry using single photon emission computed tomography/CT could be applied to investigate this issue further. Delayed (72 h) images are most suitable for drawing regions of interest for dosimetric calculations.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22183108</pmid><doi>10.1007/s00259-011-2003-x</doi><tpages>11</tpages></addata></record>
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subjects Adult
Aged
Aged, 80 and over
Cardiology
Female
Humans
Imaging
Male
Medicine
Medicine & Public Health
Middle Aged
Multimodal Imaging - methods
Neoplasm Metastasis
Neuroendocrine Tumors - diagnostic imaging
Neuroendocrine Tumors - pathology
Neuroendocrine Tumors - radiotherapy
Nuclear Medicine
Octreotide - analogs & derivatives
Oncology
Organometallic Compounds
Original Article
Orthopedics
Positron-Emission Tomography
Radiology
Radiometry
Receptors, Peptide - therapeutic use
Retrospective Studies
Time Factors
Tomography, X-Ray Computed
Young Adult
title Comparison of sequential planar 177Lu-DOTA-TATE dosimetry scans with 68Ga-DOTA-TATE PET/CT images in patients with metastasized neuroendocrine tumours undergoing peptide receptor radionuclide therapy
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