A Prospective Observational Study to Evaluate the Effects of Long-Acting Somatostatin Analogs on 68Ga-DOTATATE Uptake in Patients with Neuroendocrine Tumors
A Prospective Observational Study to Evaluate the Effects of Long-Acting Somatostatin Analogs on 68Ga-DOTATATE Uptake in Patients with Neuroendocrine Tumors
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DOI：
10.2967/jnumed.119.226332
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发表时间：
2019-12-01
影响因子：
9.3
通讯作者：
Tragardh, Elin
中科院分区：
文献类型：
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作者：
Galne, Anni;Almquist, Helen;Tragardh, Elin
患有神经内分泌肿瘤（NET）的患者通常用生长抑素类似物（SSA）治疗以控制症状和肿瘤生长。理论上，这种治疗可能会通过干扰示踪剂-受体结合而导致Ga-68-DOTATATE PET/CT生长抑素受体成像的误解。指南建议末次给药和成像之间间隔3-4周。本研究的目的是评估长效（LA）SSA治疗是否改变NET患者的Ga-68-DOTATATE摄取。方法：从2013年到2016年，296名患有或正在接受NET评估的患者被纳入这项前瞻性观察性研究。在2个主要患者人群中评价了LA SSA对示踪剂摄取的影响：在开始LA SSA治疗前接受Ga-68-DOTATATE PET/CT的患者和在开始LA SSA治疗后接受至少一次的患者，以及正在接受LA SSA治疗的患者，分析了LA SSA末次给药与PET/CT检查之间的间隔的影响。进行第三次探索性分析以评价临床疾病进展、消退或稳定的肿瘤状态是否改变Ga-68-DOTATATE的摄取。在3项分析中，比较了正常肝脏和肿瘤病变中SUVmax的测量值。结果如下：治疗前正常肝脏的中位SUVmax（8.6;四分位距，7.4-10.2）显著高于治疗开始后（6.0; 4.7-8.0）（P
Patients with neuroendocrine tumors (NETs) are often treated with somatostatin analogs (SSAs) for control of symptoms and tumor growth. Such therapy could theoretically lead to misinterpretation of somatostatin receptor imaging with Ga-68-DOTATATE PET/CT by interfering with tracer-receptor binding. Guidelines recommend an interval of 3-4 wk between the last dose and imaging. The aim of this study was to evaluate if long-acting (LA) SSA treatment changes the uptake of Ga-68-DOTATATE in patients with NETs. Methods: From 2013 to 2016, 296 patients with, or under evaluation for, NETs were included in this prospective observational study. The effect of LA SSA on tracer uptake was evaluated in 2 main patient populations: those undergoing Ga-68-DOTATATE PET/CT before starting LA SSA treatment and at least once afterward, and those receiving ongoing LA SSA therapy, in whom the effect of the interval between the last dose of LA SSA and the PET/CT exam was analyzed. A third, explorative, analysis was performed to evaluate if clinical disease progression, regression, or stable tumor status changed the uptake of Ga-68-DOTATATE. In the 3 analyses, measurements of SUVmax in normal liver and tumor lesions were compared. Results: The median SUVmax in normal liver was significantly higher before treatment (8.6; interquartile range, 7.4-10.2) than after treatment initiation (6.0; 4.7-8.0) (P