Vertebral metastases from neuroendocrine tumours: How to avoid false positives on 68Ga-DOTA-TOC PET using CT pattern analysis?
| Autor: | Jessica Ohnona, Françoise Montravers, Mathieu Gauthé, Valérie Nataf, Fernando Ruiz Santiago, Jean-Noël Talbot, Nathalie Testart Dardel |
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| Rok vydání: | 2018 |
| Předmět: |
PET-CT
medicine.medical_specialty business.industry Ultrasound Standardized uptake value General Medicine medicine.disease 030218 nuclear medicine & medical imaging Vertebra Metastasis Lesion 03 medical and health sciences 0302 clinical medicine Isotopes of gallium medicine.anatomical_structure 030220 oncology & carcinogenesis Medicine Radiology Nuclear Medicine and imaging Radiology medicine.symptom business neoplasms Neuroradiology |
| Zdroj: | European Radiology. 28:3943-3952 |
| ISSN: | 1432-1084 0938-7994 |
| DOI: | 10.1007/s00330-017-5294-x |
| Popis: | To develop criteria to improve discrimination between vertebral metastases from neuroendocrine tumours (NETs) and benign bone lesions on PET combined with CT using DOTA-D-Phe1-Tyr3-octreotide labelled with gallium-68 (68Ga-DOTA-TOC). In 535 NET patients, 68Ga-DOTA-TOC PET/CT examinations were reviewed retrospectively for vertebral CT lesions and/or PET foci. For each vertebral PET abnormality, appearance on CT, biological volume (BV), standardized uptake value (SUVmax) and ratios to those of reference organs were determined. All vertebral abnormalities were characterized as a metastasis, a typical vertebral haemangioma (VH) or other benign lesion. In 79 patients (14.8 %), we found 107 metastases, 34 VHs and 31 other benign lesions in the spine. The optimal cut-off values to differentiate metastases from benign lesions were BV ≥0.72 cm3, SUVmax ≥2, SUVmax ratio to a reference vertebra ≥2.1, to liver ≥0.28 and to spleen ≥0.14. They corresponded to lesion-based 68Ga-DOTA-TOC PET/CT sensitivity of 87 %, 98 %, 97 %, 99 % and 94 %, and specificity of 55 %, 100 %, 90 %, 97 %, 100 %, respectively. The high sensitivity of 68Ga-DOTA-TOC-PET/CT in detecting NET vertebral metastases was confirmed; this study showed that specificity could be improved by combining CT features and quantifying 68Ga-DOTA-TOC uptake. • Bone metastases in neuroendocrine tumours correlate with prognosis. • Benign bone lesions may mimic metastases on 68 Ga-DOTA-TOC PET/CT imaging. • The specific polka-dot CT pattern may be missing in some vertebral haemangiomas. • Lesion atypical for haemangiomas can be better characterized by quantifying 68 Ga-DOTA-TOC uptake. |
| Databáze: | OpenAIRE |
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