The Impact of 68 Gallium DOTA PET/CT in Managing Patients With Sporadic and Familial Pancreatic Neuroendocrine Tumours

• Published in: Frontiers in endocrinology (Lausanne) 2021, Vol.12, p.654975
• Main Authors: Cuthbertson, Daniel J, Barriuso, Jorge, Lamarca, Angela, Manoharan, Prakash, Westwood, Thomas, Jaffa, Matthew, Fenwick, Stephen W, Nuttall, Christina, Lalloo, Fiona, Prachalias, Andreas, Pizanias, Michail, Wieshmann, Hulya, McNamara, Mairead G, Hubner, Richard, Srirajaskanthan, Raj, Vivian, Gillian, Ramage, John, Weickert, Martin O, Pritchard, D Mark, Vinjamuri, Sobhan, Valle, Juan, Yip, Vincent S
• Format: Article
• Language: English
• Subjects: Aged; Chelating Agents - chemistry; Cross-Sectional Studies; Disease Management; Female; Follow-Up Studies; Gallium Radioisotopes - metabolism; Heterocyclic Compounds, 1-Ring - chemistry; Humans; Male; Middle Aged; Neuroendocrine Tumors - diagnostic imaging; Neuroendocrine Tumors - metabolism; Neuroendocrine Tumors - secondary; Neuroendocrine Tumors - surgery; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - metabolism; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Positron-Emission Tomography - methods; Prognosis; Radiopharmaceuticals - metabolism; Retrospective Studies
• ISSN: 1664-2392; 1664-2392

Pancreatic neuroendocrine tumours (panNETs) arise sporadically or as part of a genetic predisposition syndrome. CT/MRI, endoscopic ultrasonography and functional imaging using Octreoscan localise and stage disease. This study aimed to evaluate the complementary role of Gallium ( Ga)-DOTA PET/CT in managing patients with panNETs. A retrospective study conducted across three tertiary UK NET referral centres. Demographic, clinical, biochemical, cross-sectional and functional imaging data were collected from patients who had undergone a Ga-DOTA PET/CT scan for a suspected panNET. We collected data for 183 patients (97 male): median (SD) age 63 (14.9) years, 89.1 9.3% (n=163 vs. 17) alive dead (3 data missing), 141 sporadic 42 familial (MEN1, n=36; 85.7%) panNETs. Non-functional functional tumours comprised 73.2 21.3% (n=134 39) (10 missing). Histological confirmation was available in 89% of individuals (n=163) but tumour grading (Ki67 classiifcation) was technically possible only in a smaller cohort (n=143): grade 1, 50.3% (n=72); grade 2, 46.2% (n=66) and grade 3, 3.5% (n=5) (40 histopathological classification either not technically feasible or biopsy not perfomed). 60.1% (n=110) were localised, 14.2% (n=26) locally advanced and 23.5% (n=43) metastatic (4 missing). 224 Ga-DOTA PET/CT scans were performed in total for: diagnosis/staging 40% (n=88), post-operative assessment/clinical surveillance 53% (n=117) and consideration of peptide receptor radionuclide therapy (PRRT) 8% (n=17) (2 missing). PET/CT results confirmed other imaging findings (53%), identified new disease sites (28.5%) and excluded suspected disease (5%). Overall, Ga-DOTA PET/CT imaging findings provided additional information in 119 (54%) patients and influenced management in 85 (39%) cases. Ga-DOTA PET/CT imaging more accurately stages and guides treatment in patients with sporadic/familial panNETs with newly diagnosed/recurrent disease.