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Dual-tracer (68Ga-DOTATOC and 18F-FDG-)-PET/CT scan and G1-G2 non-functioning pancreatic neuroendocrine tumors: A single-center retrospective evaluation of 124 non-metastatic resected cases
Neuroendocrinology ( IF 4.1 ) Pub Date : 2021-01-28 , DOI: 10.1159/000514809
Salvatore Paiella 1 , Luca Landoni 1 , Sarah Tebaldi 1 , Michele Zuffante 2 , Matteo Salgarello 3 , Sara Cingarlini 4 , Mirko D'Onofrio 5 , Alice Parisi 6 , Giacomo Deiro 1 , Erminia Manfrin 6 , Beatrice Bianchi 1 , Greta Montagnini 1 , Stefano Francesco Crinò 7 , Claudio Bassi 1 , Roberto Salvia 1
Affiliation  

Introduction:The combined use of 68Gallium [68GA]-DOTA-peptides and 18Fluorine-fluoro-2-deoxyglucose [18F-FDG] PET/TC scans in the work-up of pancreatic neuroendocrine tumors (PanNETs) is controversial. This study aimed at assessing both tracers’ capability to identify tumors and to assess its association with pathological predictors of recurrence. Methods:Prospectively collected, preoperative, dual-tracer PET/CT scan data of G1-G2, non-metastatic, PanNETs that underwent surgery between January 2013 and October 2019 were retrospectively analyzed. Results:The final cohort consisted of 124 cases. There was an approximately equal distribution of males and females(50.8%/49.2%), and G1 and G2 tumors(49.2%/50.8%). The disease was detected in 122(98.4%) and 64(51.6%) cases by 68Ga-DOTATOC and by 18F-FDG PET/CT scans, respectively, with a combined sensitivity of 99.2%. 18F-FDG-positive examinations found G2 tumors more often than G1 (59.4% versus 40.6%;p = 0.036), and 18F-FDG-positive PanNETs were larger than negative ones (median tumor size 32 mm, IQR 21 versus 26 mm, IQR 20;p = 0.019). The median Ki67 for 18F-FDG-positive and -negative examinations was 3(IQR 4) and 2(IQR 4), respectively, (p = 0.029). At least one pathologic predictor of recurrence was present in 74.6% of 18F-FDG-positive cases (versus 56.7%;p = 0.039), whereas this was not found when dichotomizing the PanNETs by their dimensions (≤/> 20 mm). None of the two tracers predicted nodal metastasis. ROC curve analysis showed that 18F-FDG uptake higher than 4.2 had a sensitivity of 49.2%, and specificity of 73.3% for differentiating G1 from G2 (AUC=0.624, p=0.009). Conclusion: The complementary adoption of 68Ga-DOTATOC and 18F-FDG tracers may be valuable in the diagnostic work-up of PanNETs despite not being a game-changer for the management of PanNETs ≤ 20 mm.


中文翻译:

双示踪剂(68Ga-DOTATOC 和 18F-FDG-)-PET/CT 扫描和 G1-G2 无功能胰腺神经内分泌肿瘤:124 例非转移性切除病例的单中心回顾性评估

简介:68Gallium [68GA]-DOTA-peptides 和 18Fluorine-fluoro-2-deoxyglucose [18F-FDG] PET/TC 扫描在胰腺神经内分泌肿瘤(PanNETs)检查中的联合应用存在争议。本研究旨在评估两种示踪剂识别肿瘤的能力,并评估其与复发病理预测因子的关联。方法:回顾性分析2013年1月至2019年10月接受手术的G1-G2期、非转移性、PanNETs术前双示踪PET/CT扫描数据。结果:最终队列由124例组成。男性和女性的分布大致相等(50.8%/49.2%),G1和G2肿瘤(49.2%/50.8%)。分别通过 68Ga-DOTATOC 和 18F-FDG PET/CT 扫描在 122 例(98.4%)和 64 例(51.6%)中检测到该疾病,综合灵敏度为 99.2%。18F-FDG 阳性检查发现 G2 肿瘤比 G1 更常见(59.4% vs 40.6%;p = 0.036),18F-FDG 阳性 PanNETs 大于阴性肿瘤(中位肿瘤大小 32 mm,IQR 21 vs 26 mm, IQR 20;p = 0.019)。18F-FDG 阳性和阴性检查的中位 Ki67 分别为 3(IQR 4) 和 2(IQR 4) (p = 0.029)。在 74.6% 的 18F-FDG 阳性病例中(相对于 56.7%;p = 0.039)存在至少一种复发的病理预测因子,而在按尺寸 (≤/> 20 mm) 对 PanNET 进行二分法时未发现这一点。两种示踪剂均未预测淋巴结转移。ROC 曲线分析显示,高于 4.2 的 18F-FDG 摄取对区分 G1 和 G2 的敏感性为 49.2%,特异性为 73.3%(AUC=0.624,p=0.009)。结论:
更新日期:2021-01-28
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