Long-Acting Somatostatin Analog Therapy Differentially Alters 68Ga-DOTATATE Uptake in Normal Tissues Compared with Primary Tumors and Metastatic Lesions
Long-Acting Somatostatin Analog Therapy Differentially Alters 68Ga-DOTATATE Uptake in Normal Tissues Compared with Primary Tumors and Metastatic Lesions
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DOI：
10.2967/jnumed.117.192203
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发表时间：
2018-02-01
影响因子：
9.3
通讯作者：
Scott, Andrew M.
中科院分区：
文献类型：
--
作者：
Ayati, Narjess;Lee, Sze Ting;Scott, Andrew M.
合成的生长抑素类似物通过干扰肿瘤检测被认为是生长抑素受体成像的潜在误差来源；然而，实验模型和临床研究表明奥曲肽对肿瘤的作用机制复杂。本研究的目的是评估长效生长抑素类似物治疗前Ga-68-DOTATATE的摄取是否与治疗后不同。方法：选取30例中分化至高分化神经内分泌肿瘤患者（男性15例，年龄[平均+/- SD]， 64.6 +/- 13.4岁），接受长效可重复奥曲肽（Sandostatin LAR）治疗前后行Ga-68-DOTATATE PET/CT扫描。比较奥曲肽治疗前后健康靶器官、残留原发肿瘤和各器官SUVmax最高的5个病变的SUVmax和suv平均值。结果：两次Ga-68-DOTATATE研究的平均时间间隔为9.6 +/- 7.2个月，最后一次注射Ga-68-DOTATATE与第二次注射Ga-68-DOTATATE的平均时间间隔为25.1 +/- 14.8 d。预处理后甲状腺、肝脏和脾脏的平均SUVmax和SUVmean均显著高于给予桑多他汀LAR后的值（P < 0.05）。山多他汀LAR给药前后，肝、骨、肺、淋巴结残余原发肿瘤或任何转移性病变的摄取指数无显著差异（P < 0.05）。结论：长效奥曲肽治疗可减少肝脏、脾脏和甲状腺对Ga-68-DOTATATE的摄取，但不影响残留原发肿瘤和转移灶对示踪剂的摄取。这些发现对Ga-68-DOTATATE PET/CT扫描的解释有直接影响。
Synthetic somatostatin analogs have been posed as a potential source of error in somatostatin receptor imaging through interference with tumor detection; however, experimental models and clinical studies have shown a complex mechanism of the effect of octreotide on tumors. The aimof this study was to assess whether Ga-68-DOTATATE uptake before treatment with long-acting somatostatin analogs differs from that after treatment. Methods: Thirty patients (15 men; age [mean +/- SD], 64.6 +/- 13.4 y) who had intermediately differentiated to well-differentiated neuroendocrine tumors and who underwent Ga-68-DOTATATE PET/CT scanning before and after receiving long-acting repeatable octreotide (Sandostatin LAR) were included in the study. The SUVmax and SUVmean of healthy target organs, residual primary tumor, and up to 5 lesions with the highest SUVmax in each organ were compared before and after octreotide treatment. Results: The mean time interval between the 2 Ga-68-DOTATATE studies was 9.6 +/- 7.2 mo, and the mean time gap between the last Sandostatin LAR injection and the second Ga-68-DOTATATE study was 25.1 +/- 14.8 d. The pretreatment mean SUVmax and SUVmean were both significantly higher in the thyroid, liver, and spleen (P < 0.05) than the values measured after the administration of Sandostatin LAR. No significant differences were found among the uptake indices for residual primary tumor or any metastatic lesions in the liver, bone, lung, or lymph nodes before and after Sandostatin LAR administration (P > 0.05). Conclusion: Long-acting octreotide treatment diminished Ga-68-DOTATATE uptake in the liver, spleen, and thyroid but did not compromise tracer uptake in residual primary tumor and metastatic lesions. These findings have a direct impact on the interpretation of Ga-68-DOTATATE PET/CT scans.