Impact of 68Ga-DOTATATE PET/CT on the Surgical Management of Primary Neuroendocrine Tumors of the Pancreas or Ileum
Impact of 68Ga-DOTATATE PET/CT on the Surgical Management of Primary Neuroendocrine Tumors of the Pancreas or Ileum
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DOI：
10.1245/s10434-014-3981-2
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发表时间：
2015-01-01
影响因子：
3.7
通讯作者：
Haug, Alexander R.
中科院分区：
文献类型：
--
作者：
Ilhan, Harun;Fendler, Wolfgang P.;Haug, Alexander R.
切除术是患有回肠或胰腺神经内分泌肿瘤（NET）的患者的唯一治疗方法。准确的术前影像学对于手术计划至关重要，因为即使是微小且远处转移的发现也可能对手术治疗产生深远的影响。我们大学医院对 44 名患有回肠 (n = 26) 或胰腺 (n = 18) NET 的患者术前进行了 Ga-68-DOTATATE PET/CT 检查。由核医学和内脏外科专家组成的跨学科团队对数据进行了回顾性分析。在获得 PET/CT 结果之前和之后记录了预期的手术治疗。研究小组判断影像学结果是否提供了与手术计划相关的额外信息。影像学结果改变了 44 名患者中的 9 名 (20%) 的手术治疗，更具体地说，是 26 名回肠 NET 患者中的 3 名 (12%) 和 18 名胰腺 NET 患者中的 6 名 (33%)。 PET/CT 结果导致 6 例患者（回肠和胰腺各 3 例）采取了更具侵入性的手术方法，并为 3 名胰腺 NET 患者采取了侵入性较小的策略。虽然 44 名患者中 35 名患者的 PET/CT 结果并未改变治疗，但生长抑素受体成像仍为 95% 以上的病例提供了手术计划的额外信息。 Ga-68-DOTATATE PET/CT 在术前检查中提供的额外信息显着影响了我们五分之一的 NET 患者的手术治疗，尤其是三分之一患有胰腺 NET 的患者的手术治疗。
Resection is the only curative treatment in patients suffering from neuroendocrine tumors (NETs) of the ileum or the pancreas. Accurate preoperative imaging is critical for surgical planning, as even findings of small and distant metastases may profoundly influence surgical management.Ga-68-DOTATATE PET/CT was performed preoperatively in 44 patients suffering from NET of the ileum (n = 26) or the pancreas (n = 18) before surgery at our University Hospital. Data were analyzed retrospectively by an interdisciplinary team of nuclear medicine and visceral surgery specialists. Intended surgical management was documented before and after availability of PET/CT findings. The team judged whether the imaging findings provided additional information relevant to surgical planning.Imaging results altered surgical management in 9 of 44 (20 %) patients, more specifically in 3 of 26 (12 %) patients with NET of the ileum and in 6 of 18 (33 %) patients with NET of the pancreas. PET/CT findings led to a more invasive surgical approach in 6 cases (3 each of ileum and pancreas) and to a less invasive strategy in 3 patients with NET of the pancreas. Although PET/CT results did not alter management in 35 of 44 patients, somatostatin receptor imaging still provided additional information for surgery planning in more than 95 % of the cases.Additional information provided by Ga-68-DOTATATE PET/CT in the preoperative workup significantly influences surgical management in one-fifth of our NET patients and, notably, one-third of those suffering from NET of the pancreas.