Detection of Bone Metastases by 68Ga-DOTA-SSAs and 18F-FDG PET/CT: A Two-Center Head-to-Head Study of Gastroenteropancreatic Neuroendocrine Neoplasms.

Abstract

Purpose:

This study aimed to assess the efficacy of dual-tracer [68Ga-DOTA-somatostatin receptor analogs (SSAs) and 18F-fluorodeoxyglucose (FDG)] positron emission tomography/computed tomography (PET/CT) imaging for detecting bone metastases (BMs) in patients with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs).

Methods:

We retrospectively enrolled 74 GEP-NEN patients with BMs from two centers, who underwent dual-tracer PET/CT from January 2014 to March 2021. We compared and analyzed effectiveness of the dual PET/CT imaging techniques on the BMs, based on 18F-FDG and 68Ga-DOTA-SSAs. Specifically, we analyzed the imaging results using χ 2 tests for classification variables, paired-sample tests for number of BMs, Wilcoxon's signed rank test for number of lesions, and the Kruskal-Wallis test for standard uptake value (SUV) ratio comparison. The correlation of dual-tracer SUVmax with Ki-67 index was analyzed by Spearman's correlation coefficient.

Results:

The detection efficiencies of dual-tracer PET/CT imaging in patients with different pathologies showed discordant for detecting liver metastases and BMs in group neuroendocrine tumor (NET) G3, 68Ga-DOTA-SSAs was better at detecting BMs for NET G3 (P=0.049 for SUVT/B and P=0.026 for the number of metastatic lesions). In addition, statistical significance was found among osteogenesis group, osteolysis group, and the no-change group (for bone SUVT/B value detected by 18F-FDG and Ki-67 index, osteogenesis group < osteolysis group; for bone SUVT/B detected by 68Ga-DOTA-SSAs, osteogenesis group > the no-change group). What is more, liver and bone SUVmax and Ki-67 index were positively correlated in 18F-FDG imaging (P < 0.001 for liver; P=0.002 for bone), and negatively correlated in 68Ga-DOTA-SSAs imaging (P < 0.001 for liver; P=0.039 for bone).

Conclusions:

68Ga-DOTA-SSAs was superior to 18F-FDG for detecting BMs in NET G1/G2 (well and moderately differentiated NETs), as well as in NET G3 (poorly differentiated NETs). Relatively good differentiation was observed in the osteogenesis group. In addition, dual-tracer PET/CT imaging results were observably correlated with tumor differentiation.

• Authors: Rui Tian, Qing Xie, Fei Yu, Changzhi Du, Xiaochen Yao, Shiming Zang, Chuan Zhang, Pengjun Zhang, Guoqiang Shao, Zhi Yang, Feng Wang, Jiangyuan Yu
• Journal: Contrast media & molecular imaging (Contrast Media Mol Imaging) Vol. 2022 Pg. 1750132 ( 2022) ISSN: 1555-4317 [Electronic] England
• PMID: 36447752 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 Rui Tian et al.

Chemical References

• Fluorodeoxyglucose F18
• Receptors, Somatostatin
• Gallium Radioisotopes
• 1,4,7,10-tetraazacyclododecane- 1,4,7,10-tetraacetic acid
• Ki-67 Antigen

Topics

• Humans
• Positron Emission Tomography Computed Tomography
• Fluorodeoxyglucose F18
• Receptors, Somatostatin
• Gallium Radioisotopes
• Osteolysis
• Ki-67 Antigen
• Retrospective Studies
• Neuroendocrine Tumors (diagnostic imaging)
• Gastrointestinal Neoplasms
• Bone Neoplasms