Prediction of the aggressiveness of non-functional pancreatic neuroendocrine tumors based on the dual-tracer PET/CT

被引：23

作者：

Majala, Susanna ^{[1
,2
]}

Seppanen, Hanna ^{[3
,4
]}

Kemppainen, Jukka ^{[2
,5
]}

Sundstrom, Jari ^{[6
]}

Schalin-Jantti, Camilla ^{[4
,7
]}

Gullichsen, Risto ^{[1
]}

Schildt, Jukka ^{[8
]}

Mustonen, Harri ^{[4
,9
]}

Vesterinen, Tiina ^{[10
,11
,12
]}

Arola, Johanna ^{[10
,11
]}

Kauhanen, Saila ^{[1
,2
]}

机构：

[1] Turku Univ Hosp, Div Digest Surg & Urol, POB 52, FIN-20521 Turku, Finland

[2] Turku Univ Hosp, Turku PET Ctr, POB 52, FIN-20521 Turku, Finland

[3] Univ Helsinki, Fac Med, Translat Canc Med Res Program, Dept Abdominal Surg, POB 340, FIN-00029 Helsinki, Finland

[4] Helsinki Univ Hosp, POB 340, FIN-00029 Helsinki, Finland

[5] Turku Univ Hosp, Dept Clin Physiol & Nucl Med, POB 52, FIN-20521 Turku, Finland

[6] Turku Univ Hosp, Dept Pathol, POB 52, FIN-20521 Turku, Finland

[7] Univ Helsinki, Abdominal Ctr, Dept Endocrinol, POB 340, FIN-00029 Helsinki, Finland

[8] Helsinki Univ Hosp, Dept Clin Physiol & Nucl Med, Haartmaninkatu 4, FIN-00029 Helsinki, Finland

[9] Univ Helsinki, Dept Surg, POB 340, FIN-00029 Helsinki, Finland

[10] Univ Helsinki, Dept Pathol, HUSLAB, POB 400, FIN-00029 Helsinki, Finland

[11] Helsinki Univ Hosp, POB 400, FIN-00029 Helsinki, Finland

[12] Univ Helsinki, HiLIFE, Inst Mol Med Finland, POB 20, FIN-00014 Helsinki, Finland

来源：

EJNMMI RESEARCH | 2019年 / 9卷 / 01期

关键词：

NF-PNET; F-18-FDG-PET/CT; Ga-68-DOTANOC-PET/CT; prospective study; surgical management; Ki-67; SOMATOSTATIN RECEPTOR SCINTIGRAPHY; ENETS CONSENSUS GUIDELINES; F-18-FDG PET; GA-68-DOTANOC PET/CT; PROGNOSTIC VALUE; MANAGEMENT; SURVIVAL; TOMOGRAPHY; RESECTION; KI-67;

D O I：

10.1186/s13550-019-0585-7

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Background Predicting the aggressive behavior of non-functional pancreatic neuroendocrine tumors (NF-PNET) remains controversial. We wanted to explore, in a prospective setting, whether the diagnostic accuracy can be improved by dual-tracer functional imaging Ga-68-DOTANOC and F-18-FDG-PET/CT in patients with NF-PNETs. Methods Thirty-one patients with NF-PNET (90% asymptomatic) underwent PET-imaging with F-18-FDG and Ga-68-DOTANOC, followed by surgery (n = 20), an endoscopic ultrasonography and fine-needle biopsy (n = 2) or follow-up (n = 9). A focal activity on PET/CT greater than the background that could not be identified as physiological activity was considered to indicate tumor tissue. The imaging results were compared to histopathology. The mean follow-up time was 31.3 months. Results Thirty-one patients presented a total of 53 lesions (40 histologically confirmed) on PET/CT. Thirty patients had a Ga-68-DOTANOC-positive tumor (sensitivity 97%) and 10 patients had an F-18-FDG-positive tumor. In addition, one Ga-68-DOTANOC-negative patient was F-18-FDG-positive. F-18-FDG-PET/CT was positive in 19% (3/16) of the G1 tumors, 63% (5/8) of the G2 tumors and 1/1 of the well-differentiated G3 tumor. Ga-68-DOTANOC-PET/CT was positive in 94% of the G1 tumors, 100% of the G2 tumors and 1/1 of the well-differentiated G3 tumor. Two out of six (33%) of the patients with lymph node metastases (LN+) were F-18-FDG-positive. The F-18-FDG-PET/CT correlated with tumor Ki-67 (P = 0.021). Further, the Krenning score correlated with tumor Ki-67 (P = 0.013). F-18-FDG-positive tumors were significantly larger than the F-18-FDG-negative tumors (P = 0.012). F-18-FDG-PET/CT showed a positive predictive value of 78% in the detection of potentially aggressive tumors (G2, G3, or LN + PNETs); the negative predictive value was 69%. Conclusions F-18-FDG-PET/CT is useful to predict tumor grade but not the LN+ of NF-PNETs. Patients with F-18-FDG-avid NF-PNETs should be referred for surgery. The Ga-68-DOTANOC-PET/CT also has prognostic value since the Krenning score predicts the histopathological tumor grade.

引用

页数：12