Our objective was to evaluate the prognostic value of somatostatin receptor tumor burden on ⁶⁸Ga-DOTATOC PET/CT in patients with well-differentiated (WD) neuroendocrine tumors (NETs). Methods: We retrospectively analyzed the ⁶⁸Ga-DOTATOC PET/CT scans of 84 patients with histologically confirmed WD NETs (51 grade 1, 30 grade 2, and 3 grade 3). For each PET/CT scan, all ⁶⁸Ga-DOTATOC–avid lesions were independently segmented by 2 operators using a customized threshold based on the healthy liver SUV_max (LIFEx, version 5.1). Somatostatin receptor–expressing tumor volume (SRETV) and total lesion somatostatin receptor expression (TLSRE = SRETV x SUV_mean) were extracted for each lesion, and then whole-body SRETV and TLSRE (SRETVwb and TLSREwb, respectively) were defined as the sum of SRETV and TLSRE, respectively, for all segmented lesions in each patient. Time to progression (TTP) was defined as the combination of disease-free survival in patients undergoing curative surgery (n = 10) and progression-free survival for patients with unresectable or metastatic disease (n = 74). TTP and overall survival were calculated by Kaplan–Meier analysis, log-rank testing, and the Cox proportional-hazards regression model. Results: After a median follow-up of 15.5 mo, disease progression was confirmed in 35 patients (41.7%) and 14 patients died. A higher SRETVwb (>39.1 cm³) and TLSREwb (>306.8 g) correlated significantly with a shorter median TTP (12 mo vs. not reached; P < 0.001). In multivariate analysis, SRETVwb (P = 0.005) was the only independent predictor of TTP regardless of histopathologic grade and TNM staging. Conclusion: According to our results, SRETVwb and TLSREwb extracted from ⁶⁸Ga-DOTATOC PET/CT could predict TTP or overall survival and might have important clinical utility in the management of patients with WD NETs.

我们的目的是评估生长抑素受体肿瘤负荷对高分化 (WD) 神经内分泌肿瘤 (NETs) 患者⁶⁸ Ga-DOTATOC PET/CT 的预后价值。方法：我们回顾性分析了84 名组织学证实的 WD NET 患者（51 名 1 级、30 名 2 级和 3 名 3 级）患者的^{68 次Ga-DOTATOC PET/CT 扫描。}对于每次 PET/CT 扫描，所有⁶⁸个 Ga-DOTATOC-avid 病变均由 2 名操作员使用基于健康肝脏 SUV_最大值（LIFEx，5.1 版）的自定义阈值独立分割。生长抑素受体表达肿瘤体积 (SRETV) 和总病灶生长抑素受体表达 (TLSRE = SRETV x SUV_平均值) 提取每个病灶，然后将全身 SRETV 和 TLSRE（分别为 SRETVwb 和 TLSREwb）分别定义为每个患者所有分段病灶的 SRETV 和 TLSRE 之和。进展时间 (TTP) 定义为接受根治性手术的患者的无病生存期 ( n = 10) 和不可切除或转移性疾病患者的无进展生存期 ( n = 74)。通过 Kaplan-Meier 分析、对数秩检验和 Cox 比例风险回归模型计算 TTP 和总生存期。结果：中位随访 15.5 个月后，35 名患者（41.7%）确认疾病进展，14 名患者死亡。更高的 SRETVwb (>39.1 cm ³) 和 TLSREwb (>306.8 g) 与较短的中位 TTP 显着相关（12 个月与未达到；P < 0.001）。在多变量分析中，无论组织病理学分级和 TNM 分期如何，SRETVwb ( P = 0.005) 是 TTP 的唯一独立预测因子。结论：根据我们的结果，从⁶⁸ Ga-DOTATOC PET/CT 中提取的 SRETVwb 和 TLSREwb 可以预测 TTP 或总生存期，并可能在 WD NETs 患者的管理中具有重要的临床实用性。