Cargando…

Dual Tracer 68Ga-DOTATOC and 18F-FDG PET Improve Preoperative Evaluation of Aggressiveness in Resectable Pancreatic Neuroendocrine Neoplasms

Purpose: To define an imaging risk profile in a population of patients affected by Pancreatic neuroendocrine neoplasms (PanNENs) candidates to surgery, by assessing the predictive role of 68Ga-DOTATOC and 18F-FDG PET/CT and PET/MR derived parameters in risk stratification, particularly regarding his...

Descripción completa

Detalles Bibliográficos
Autores principales: Mapelli, Paola, Partelli, Stefano, Salgarello, Matteo, Doraku, Joniada, Muffatti, Francesca, Schiavo Lena, Marco, Pasetto, Stefano, Bezzi, Carolina, Bettinardi, Valentino, Andreasi, Valentina, Rancoita, Paola Maria Vittoria, Gianolli, Luigi, Picchio, Maria, Falconi, Massimo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912034/
https://www.ncbi.nlm.nih.gov/pubmed/33525712
http://dx.doi.org/10.3390/diagnostics11020192
_version_ 1783656482169946112
author Mapelli, Paola
Partelli, Stefano
Salgarello, Matteo
Doraku, Joniada
Muffatti, Francesca
Schiavo Lena, Marco
Pasetto, Stefano
Bezzi, Carolina
Bettinardi, Valentino
Andreasi, Valentina
Rancoita, Paola Maria Vittoria
Gianolli, Luigi
Picchio, Maria
Falconi, Massimo
author_facet Mapelli, Paola
Partelli, Stefano
Salgarello, Matteo
Doraku, Joniada
Muffatti, Francesca
Schiavo Lena, Marco
Pasetto, Stefano
Bezzi, Carolina
Bettinardi, Valentino
Andreasi, Valentina
Rancoita, Paola Maria Vittoria
Gianolli, Luigi
Picchio, Maria
Falconi, Massimo
author_sort Mapelli, Paola
collection PubMed
description Purpose: To define an imaging risk profile in a population of patients affected by Pancreatic neuroendocrine neoplasms (PanNENs) candidates to surgery, by assessing the predictive role of 68Ga-DOTATOC and 18F-FDG PET/CT and PET/MR derived parameters in risk stratification, particularly regarding histological features of aggressive behaviour. Patients and methods: Retrospective study including 83 patients (53 males, 30 females; median age: 60 years, interquartile range 52–66.5), who underwent to 68Ga-DOTATOC (PET/CT: n = 77; PET/MR: n = 6) and, 68/83 patients, also to 18F-FDG PET (PET/CT: n = 65; PET/MR: n = 3) before surgery for PanNEN between 2011 and 2019, with available histological and follow-up data. The PET scans were interpreted with both qualitative (positive vs. negative) and semiquantitative measurements as follows: maximum and mean standardized uptake value (SUVmax and SUVmean) for both 18F-FDG and 68Ga-DOTATOC scans, metabolic tumour volume (MTV) and tumour lesion glycolysis (TLG) for 18F-FDG scans and somatostatin receptor density (SRD) and total lesion somatostatin receptor density (TLSRD) for 68Ga-DOTATOC PET. Receiver Operating Characteristics (ROC) curve analysis was used to investigate the performance of several PET parameters in predicting tumour stage or characteristic. For each PET parameter, the optimal cut-off was derived. Logistic regression analysis was used to assess if the PET parameters, categorized with the optimal cut-off values, were able to predict significantly the corresponding tumour stage or characteristic. Results: Overall, 29 (35%) patients had G1, 49 (59%) a G2 and five (6%) had a G3 PanNEN. The median Ki-67 index was 4% (interquartile range: 1–8%). SRD and TLSRD significantly discriminated between pT3 or pT4 PanNEN versus pT1 or pT2, as well as 18F-FDG MTV and TLG. 68Ga-DOTATOC SUVmax was able to significantly predict the presence of distant metastases with a threshold of 51.27 (sensitivity and specificity of 85.7 and 68.1%, respectively). 18F-FDG MTV and TLG were predictors of angioinvasion. The cut-off threshold for MTV was 7.98 (sensitivity and specificity of 69.7 and 82.4%, respectively) (p = 0.0004) whereas the cut-off for TLG was 32.4 (sensitivity and specificity of 69.7% and 82.4%, respectively) (p = 0.0004). Conclusion: Dual tracer 68Ga-DOTATOC and 18F-FDG PET scans provide relevant information regarding tumour behaviour and aggressiveness, implementing the diagnostic preoperative work-up.
format Online
Article
Text
id pubmed-7912034
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-79120342021-02-28 Dual Tracer 68Ga-DOTATOC and 18F-FDG PET Improve Preoperative Evaluation of Aggressiveness in Resectable Pancreatic Neuroendocrine Neoplasms Mapelli, Paola Partelli, Stefano Salgarello, Matteo Doraku, Joniada Muffatti, Francesca Schiavo Lena, Marco Pasetto, Stefano Bezzi, Carolina Bettinardi, Valentino Andreasi, Valentina Rancoita, Paola Maria Vittoria Gianolli, Luigi Picchio, Maria Falconi, Massimo Diagnostics (Basel) Article Purpose: To define an imaging risk profile in a population of patients affected by Pancreatic neuroendocrine neoplasms (PanNENs) candidates to surgery, by assessing the predictive role of 68Ga-DOTATOC and 18F-FDG PET/CT and PET/MR derived parameters in risk stratification, particularly regarding histological features of aggressive behaviour. Patients and methods: Retrospective study including 83 patients (53 males, 30 females; median age: 60 years, interquartile range 52–66.5), who underwent to 68Ga-DOTATOC (PET/CT: n = 77; PET/MR: n = 6) and, 68/83 patients, also to 18F-FDG PET (PET/CT: n = 65; PET/MR: n = 3) before surgery for PanNEN between 2011 and 2019, with available histological and follow-up data. The PET scans were interpreted with both qualitative (positive vs. negative) and semiquantitative measurements as follows: maximum and mean standardized uptake value (SUVmax and SUVmean) for both 18F-FDG and 68Ga-DOTATOC scans, metabolic tumour volume (MTV) and tumour lesion glycolysis (TLG) for 18F-FDG scans and somatostatin receptor density (SRD) and total lesion somatostatin receptor density (TLSRD) for 68Ga-DOTATOC PET. Receiver Operating Characteristics (ROC) curve analysis was used to investigate the performance of several PET parameters in predicting tumour stage or characteristic. For each PET parameter, the optimal cut-off was derived. Logistic regression analysis was used to assess if the PET parameters, categorized with the optimal cut-off values, were able to predict significantly the corresponding tumour stage or characteristic. Results: Overall, 29 (35%) patients had G1, 49 (59%) a G2 and five (6%) had a G3 PanNEN. The median Ki-67 index was 4% (interquartile range: 1–8%). SRD and TLSRD significantly discriminated between pT3 or pT4 PanNEN versus pT1 or pT2, as well as 18F-FDG MTV and TLG. 68Ga-DOTATOC SUVmax was able to significantly predict the presence of distant metastases with a threshold of 51.27 (sensitivity and specificity of 85.7 and 68.1%, respectively). 18F-FDG MTV and TLG were predictors of angioinvasion. The cut-off threshold for MTV was 7.98 (sensitivity and specificity of 69.7 and 82.4%, respectively) (p = 0.0004) whereas the cut-off for TLG was 32.4 (sensitivity and specificity of 69.7% and 82.4%, respectively) (p = 0.0004). Conclusion: Dual tracer 68Ga-DOTATOC and 18F-FDG PET scans provide relevant information regarding tumour behaviour and aggressiveness, implementing the diagnostic preoperative work-up. MDPI 2021-01-28 /pmc/articles/PMC7912034/ /pubmed/33525712 http://dx.doi.org/10.3390/diagnostics11020192 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mapelli, Paola
Partelli, Stefano
Salgarello, Matteo
Doraku, Joniada
Muffatti, Francesca
Schiavo Lena, Marco
Pasetto, Stefano
Bezzi, Carolina
Bettinardi, Valentino
Andreasi, Valentina
Rancoita, Paola Maria Vittoria
Gianolli, Luigi
Picchio, Maria
Falconi, Massimo
Dual Tracer 68Ga-DOTATOC and 18F-FDG PET Improve Preoperative Evaluation of Aggressiveness in Resectable Pancreatic Neuroendocrine Neoplasms
title Dual Tracer 68Ga-DOTATOC and 18F-FDG PET Improve Preoperative Evaluation of Aggressiveness in Resectable Pancreatic Neuroendocrine Neoplasms
title_full Dual Tracer 68Ga-DOTATOC and 18F-FDG PET Improve Preoperative Evaluation of Aggressiveness in Resectable Pancreatic Neuroendocrine Neoplasms
title_fullStr Dual Tracer 68Ga-DOTATOC and 18F-FDG PET Improve Preoperative Evaluation of Aggressiveness in Resectable Pancreatic Neuroendocrine Neoplasms
title_full_unstemmed Dual Tracer 68Ga-DOTATOC and 18F-FDG PET Improve Preoperative Evaluation of Aggressiveness in Resectable Pancreatic Neuroendocrine Neoplasms
title_short Dual Tracer 68Ga-DOTATOC and 18F-FDG PET Improve Preoperative Evaluation of Aggressiveness in Resectable Pancreatic Neuroendocrine Neoplasms
title_sort dual tracer 68ga-dotatoc and 18f-fdg pet improve preoperative evaluation of aggressiveness in resectable pancreatic neuroendocrine neoplasms
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912034/
https://www.ncbi.nlm.nih.gov/pubmed/33525712
http://dx.doi.org/10.3390/diagnostics11020192
work_keys_str_mv AT mapellipaola dualtracer68gadotatocand18ffdgpetimprovepreoperativeevaluationofaggressivenessinresectablepancreaticneuroendocrineneoplasms
AT partellistefano dualtracer68gadotatocand18ffdgpetimprovepreoperativeevaluationofaggressivenessinresectablepancreaticneuroendocrineneoplasms
AT salgarellomatteo dualtracer68gadotatocand18ffdgpetimprovepreoperativeevaluationofaggressivenessinresectablepancreaticneuroendocrineneoplasms
AT dorakujoniada dualtracer68gadotatocand18ffdgpetimprovepreoperativeevaluationofaggressivenessinresectablepancreaticneuroendocrineneoplasms
AT muffattifrancesca dualtracer68gadotatocand18ffdgpetimprovepreoperativeevaluationofaggressivenessinresectablepancreaticneuroendocrineneoplasms
AT schiavolenamarco dualtracer68gadotatocand18ffdgpetimprovepreoperativeevaluationofaggressivenessinresectablepancreaticneuroendocrineneoplasms
AT pasettostefano dualtracer68gadotatocand18ffdgpetimprovepreoperativeevaluationofaggressivenessinresectablepancreaticneuroendocrineneoplasms
AT bezzicarolina dualtracer68gadotatocand18ffdgpetimprovepreoperativeevaluationofaggressivenessinresectablepancreaticneuroendocrineneoplasms
AT bettinardivalentino dualtracer68gadotatocand18ffdgpetimprovepreoperativeevaluationofaggressivenessinresectablepancreaticneuroendocrineneoplasms
AT andreasivalentina dualtracer68gadotatocand18ffdgpetimprovepreoperativeevaluationofaggressivenessinresectablepancreaticneuroendocrineneoplasms
AT rancoitapaolamariavittoria dualtracer68gadotatocand18ffdgpetimprovepreoperativeevaluationofaggressivenessinresectablepancreaticneuroendocrineneoplasms
AT gianolliluigi dualtracer68gadotatocand18ffdgpetimprovepreoperativeevaluationofaggressivenessinresectablepancreaticneuroendocrineneoplasms
AT picchiomaria dualtracer68gadotatocand18ffdgpetimprovepreoperativeevaluationofaggressivenessinresectablepancreaticneuroendocrineneoplasms
AT falconimassimo dualtracer68gadotatocand18ffdgpetimprovepreoperativeevaluationofaggressivenessinresectablepancreaticneuroendocrineneoplasms