TY - JOUR
T1 - Somatostatin receptor PET/CT in restaging of typical and atypical lung carcinoids
AU - Prasad, Vikas
AU - Steffen, Ingo G.
AU - Pavel, Marianne
AU - Denecke, Timm
AU - Tischer, Elisabeth
AU - Apostolopoulou, Konstantina
AU - Pascher, Andreas
AU - Arsenic, Ruza
AU - Brenner, Winfried
N1 - Funding Information:
Munich, Nordion and Affibody AG. Timm Denecke has received payments as a lecturer as well as travel grants from Bayer Healthcare, Novartis Pharma, and Ipsen Pharma. Winfried Brenner, Ingo G Steffen, Andreas Pascher, Ruza Arsenic, Konstantina Apostolopoulou, and Elisabeth Tischer declared that they have no competing interests.
Publisher Copyright:
© 2015, Prasad et al.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background: To assess the role of somatostatin receptor (SR) PET/CT using Ga-68 DOTATOC or DOTATATE in staging and restaging of typical (TC) and atypical (AC) lung carcinoids. Methods: Clinical and PET/CT data were retrospectively analyzed in 27 patients referred for staging (N = 5; TC, N = 4; AC, N = 1) or restaging (N = 22; TC, N = 8; AC, N = 14). Maximum standardized uptake value (SUVmax) of SR-positive lesions was normalized to the SUVmax of the liver to generate SUVratio; SR PET was compared to contrast-enhanced (ce) CT. The classification system proposed by Rindi et al. (Endocr Relat Cancer. 2014;21(1):1-16, 2014) was used for classification of patients in TC and AC groups. Results: Only 18/27 patients were found to have metastases on PET/CT. Of the 186 lesions, 101 (54.3 %) were depicted on both PET and CT, 53 (28.5 %) lesions only on CT, and 32 (17.2 %) only on PET. SUVratio of lesions was significantly higher in AC as compared to TC (p < 0.001). In patients referred for restaging, additional findings on PET lead to upstaging with change in management strategy in 5/22 (22.7 %) patients (AC, N = 5; TC, N = 1). In four patients (all AC) referred for restaging and in one patient (TC) referred for staging, additional findings on CT missed on PET lead to correct staging. Conclusions: Typical and atypical carcinoid patients have complex patterns of metastases which make it necessary to combine functional SR PET and contrast-enhanced CT for appropriate restaging. In patients referred for restaging SR, PET may have a relevant impact on treatment strategy in up to 22.7 of patients with typical and atypical lung carcinoids.
AB - Background: To assess the role of somatostatin receptor (SR) PET/CT using Ga-68 DOTATOC or DOTATATE in staging and restaging of typical (TC) and atypical (AC) lung carcinoids. Methods: Clinical and PET/CT data were retrospectively analyzed in 27 patients referred for staging (N = 5; TC, N = 4; AC, N = 1) or restaging (N = 22; TC, N = 8; AC, N = 14). Maximum standardized uptake value (SUVmax) of SR-positive lesions was normalized to the SUVmax of the liver to generate SUVratio; SR PET was compared to contrast-enhanced (ce) CT. The classification system proposed by Rindi et al. (Endocr Relat Cancer. 2014;21(1):1-16, 2014) was used for classification of patients in TC and AC groups. Results: Only 18/27 patients were found to have metastases on PET/CT. Of the 186 lesions, 101 (54.3 %) were depicted on both PET and CT, 53 (28.5 %) lesions only on CT, and 32 (17.2 %) only on PET. SUVratio of lesions was significantly higher in AC as compared to TC (p < 0.001). In patients referred for restaging, additional findings on PET lead to upstaging with change in management strategy in 5/22 (22.7 %) patients (AC, N = 5; TC, N = 1). In four patients (all AC) referred for restaging and in one patient (TC) referred for staging, additional findings on CT missed on PET lead to correct staging. Conclusions: Typical and atypical carcinoid patients have complex patterns of metastases which make it necessary to combine functional SR PET and contrast-enhanced CT for appropriate restaging. In patients referred for restaging SR, PET may have a relevant impact on treatment strategy in up to 22.7 of patients with typical and atypical lung carcinoids.
KW - Atypical carcinoid
KW - Lung carcinoids
KW - Management
KW - PET/CT
KW - Restaging
KW - Somatostatin receptor
KW - Typical carcinoid
UR - http://www.scopus.com/inward/record.url?scp=84945197967&partnerID=8YFLogxK
U2 - 10.1186/s13550-015-0130-2
DO - 10.1186/s13550-015-0130-2
M3 - Article
AN - SCOPUS:84945197967
SN - 2191-219X
VL - 5
JO - EJNMMI Research
JF - EJNMMI Research
IS - 1
M1 - 53
ER -