64 Cu-DOTATATE PET/CT and Prediction of Overall and Progression-Free Survival in Patients with Neuroendocrine Neoplasms.

Autor: Carlsen EA; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.; ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark., Johnbeck CB; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.; ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark., Binderup T; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.; ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark., Loft M; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.; ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark., Pfeifer A; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.; ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark., Mortensen J; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.; ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark., Oturai P; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.; ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark., Loft A; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.; ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark., Berthelsen AK; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.; ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark., Langer SW; ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark.; Department of Oncology, Rigshospitalet, Copenhagen, Denmark; and., Knigge U; ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark.; Departments of Clinical Endocrinology and Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark., Kjaer A; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark akjaer@sund.ku.dk.; ENETS Neuroendocrine Tumor Center of Excellence, Rigshospitalet, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2020 Oct; Vol. 61 (10), pp. 1491-1497. Date of Electronic Publication: 2020 Feb 28.
DOI: 10.2967/jnumed.119.240143
Abstrakt: Overexpression of somatostatin receptors (SSTRs) in patients with neuroendocrine neoplasms (NENs) is used for both diagnosis and treatment. Receptor density may reflect tumor differentiation and thus be associated with prognosis. Noninvasive visualization and quantification of SSTR density is possible by SSTR imaging (SRI) using PET. Recently, we introduced 64 Cu-DOTATATE for SRI, and we hypothesized that uptake of this tracer could be associated with overall survival (OS) and progression-free survival (PFS). Methods: We evaluated patients with NENs who underwent 64 Cu-DOTATATE PET/CT SRI in 2 prospective studies. Tracer uptake was determined as the maximal SUV (SUV max ) for each patient. Kaplan-Meier analysis with log-rank was used to determine the predictive value of 64 Cu-DOTATATE SUV max for OS and PFS. Specificity, sensitivity, and accuracy were calculated for prediction of outcome at 24 mo after 64 Cu-DOTATATE PET/CT. Results: In total, 128 patients with NENs were included and followed for a median of 73 mo (range, 1-112 mo). During follow-up, 112 experienced disease progression, and 69 died. The optimal cutoff for 64 Cu-DOTATATE SUV max was 43.3 for prediction of PFS, with a hazard ratio of 0.56 (95% confidence interval, 0.38-0.84) for patients with an SUV max of more than 43.3. However, no significant cutoff was found for prediction of OS. In multiple Cox regression adjusted for age, sex, primary tumor site, and tumor grade, the SUV max cutoff hazard ratio was 0.50 (range, 0.32-0.77) for PFS. The accuracy was moderate for predicting PFS (57%) at 24 mo after 64 Cu-DOTATATE PET/CT. Conclusion: In this first study to report the association of 64 Cu-DOTATATE PET/CT and outcome in patients with NENs, tumor SSTR density as visualized with 64 Cu-DOTATATE PET/CT was prognostic for PFS but not OS. However, the accuracy of prediction of PFS at 24 mo after 64 Cu-DOTATATE PET/CT SRI was moderate, limiting the value on an individual-patient basis.
(© 2020 by the Society of Nuclear Medicine and Molecular Imaging.)
Databáze: MEDLINE
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