Increased 68Ga-SST uptake in the uncinate pancreatic process in new digital PET/CT machine and potential association with clinical and histologic factors in NET patients.

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License: CC BY 4.0
Serval ID
serval:BIB_FD48E6D2255E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Increased 68Ga-SST uptake in the uncinate pancreatic process in new digital PET/CT machine and potential association with clinical and histologic factors in NET patients.
Journal
EJNMMI reports
Author(s)
Firsova M., Treglia G., Sempoux C., Dromain C., Prior J.O., Schaefer N., Boughdad S.
ISSN
3005-074X (Electronic)
ISSN-L
3005-074X
Publication state
Published
Issued date
24/06/2024
Peer-reviewed
Oui
Volume
8
Number
1
Pages
18
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
A physiological increase in the uptake of [ <sup>68</sup> Ga]Ga-labeled somatostatin analogues ([ <sup>68</sup> Ga]Ga-SST) PET tracers has been reported in the uncinate pancreatic process (UP) and might be even higher in latest generation of PET/CT scanners and might be falsely interpreted as NET. We aimed to investigate the uptake of UP in a large population of NET patients who underwent [ <sup>68</sup> Ga]Ga-SST PET/CT with digital SiPM detectors. We also explored potential associations between UP uptake and various clinical, imaging, and pathological factors routinely assessed in NET patients.
We analyzed all consecutive NET patients from July 2018 to June 2022 in this retrospective, single-center study. All patients underwent a [ <sup>68</sup> Ga]Ga-SST PET/CT scan on a digital SiPM PET/CT scanner. On visual analysis, we distinguished between normal linear and homogenous UP uptake or abnormal if otherwise. We compared SUV <sub>max/mean</sub> in patients with normal UP uptake to those with abnormal UP uptake with suspicious NET lesions on contrast-enhanced CT (ce-CT) and according to the site of the primary NET (pancreatic NET vs. other), patient gender (female vs. male) and tumor grade (grade 1-2 vs. 3) using a Mann-Whitney test. We also assessed the correlation between SUV <sub>max/mean</sub> values in UP with patients' age, primary NET Ki-67 counting, and its SUV <sub>max/mean</sub> , TLA and MTV values.
We included 131 NET patients with a total of 34 [ <sup>68</sup> Ga]Ga-DOTATATE PET/CT and 113 [ <sup>68</sup> Ga]Ga-DOTATOC PET/CT scans. An abnormal UP uptake was seen in 32 patients with 65.7% of suspicious NET lesion or extrinsic compression on morphological imaging. Normal UP uptake SUV <sub>max/mean</sub> were measured in 115 [ <sup>68</sup> Ga]Ga-SST scans (78.2%) with normal UP uptake and without suspicious lesion on morphological imaging. We found an average SUV <sub>max</sub> of 12.3 ± 4.1 for [ <sup>68</sup> Ga]Ga-DOTATATE and 19.8 ± 9.8 g/ml for [ <sup>68</sup> Ga]Ga-DOTATOC, hence higher than those reported in the literature [SUVmax 5 ± 1.6 to 12.6 ± 2.2 g/ml] with significant difference with abnormal UP uptake and between both PET tracers (both p < 0.01). Significant results were a higher UP uptake on [ <sup>68</sup> Ga]Ga-DOTATOC in male patients (p = 0.02) and significant associations between UP uptake on [ <sup>68</sup> Ga]Ga-DOTATOC and SUV <sub>max/mean</sub> of the primary tumor (ρ [0.337-0.363]; p [0.01-0.02]).
We confirmed a higher and very frequent UP uptake in latest SiPM-detector [ <sup>68</sup> Ga]Ga-SST PET/CT with an even higher uptake in patients that had [ <sup>68</sup> Ga]Ga-DOTATOC PET/CT. SUV <sub>mean/max</sub> were significantly higher in abnormal UP uptake but there were overlaps with UP SUV values for both [ <sup>68</sup> Ga]Ga-SST and a correlation to morphological imaging is crucial. Besides, significant associations between UP uptake and SUV <sub>mean/max</sub> of the primary NET as well as patients' gender were seen in the larger cohort of [ <sup>68</sup> Ga]Ga-DOTATOC patients suggesting that both physiological and pathological parameters could affect UP uptake.
Keywords
Digital SiPM PET/CT scanner, NET, Physiological uptake, Uncinate pancreatic process, [68Ga]Ga-DOTATATE, [68Ga]Ga-DOTATOC, [68Ga]Ga-SST PET/CT
Pubmed
Open Access
Yes
Create date
25/06/2024 9:07
Last modification date
02/07/2024 8:37
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