Evaluation of (18)F-AlF-NOTA-octreotide for imaging neuroendocrine neoplasms: comparison with (68)Ga-DOTATATE PET/CT

OBJECTIVE: To evaluate the diagnostic efficacy of (18)F-AlF-NOTA-octreotide ((18)F-OC) PET/CT compared with that of (68)Ga-DOTATATE PET/CT. MATERIALS AND METHODS: Twenty patients (mean age: 52.65 years, range: 24–70 years) with biopsy-proven neuroendocrine neoplasms (NENs) were enrolled in this prospective study. We compared the biodistribution profiles in normal organs based on the maximum standard uptake value (SUV(max)) and mean standard uptake value (SUV(mean)), and uptake in NEN lesions by measuring the SUV(max) on (18)F-OC and (68)Ga-DOTATATE PET/CT images. The tumor-to-liver ratio (TLR) and tumor-to-spleen ratio were calculated by dividing the SUV(max) of different tumor lesions by the SUV(mean) of the liver and spleen, respectively. The Wilcoxon signed-rank test was used to compare nonparametric data. Data were expressed as the median (interquartile range). RESULTS: In most organs, there were no significant differences in the biodistribution of (68)Ga-DOTATATE and (18)F-OC. (18)F-OC had significantly lower uptake in the salivary glands and liver than (68)Ga-DOTATATE. (18)F-OC detected more lesions than (68)Ga-DOTATATE. The uptake of (18)F-OC in the tumors was higher in most patients, but the difference was not statistically significant relative to that of (68)Ga-DOTATATE. However, the TLRs of (18)F-OC were higher in most patients, including for lesions in the liver (p = 0.02) and lymph nodes (p = 0.02). CONCLUSION: Relative to (68)Ga-DOTATATE, (18)F-OC possesses favorable characteristics with similar image quality and satisfactory NEN lesion detection rates, especially in the liver due to its low background uptake. (18)F-OC therefore offers a promising clinical alternative for (68)Ga-DOTATATE. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13550-021-00797-4.