TY - JOUR
T1 - Prognostic value of whole-body PET volumetric parameters extracted from 68Ga-DOTATOC-PET/CT in well-differentiated neuroendocrine tumors
AU - Thuillier, Philippe
AU - Liberini, Virginia
AU - Grimaldi, Serena
AU - Rampado, Osvaldo
AU - Gallio, Elena
AU - De Santi, Bruno
AU - Arvat, Emanuela
AU - Piovesan, Alessandro
AU - Filippi, Roberto
AU - Abgral, Ronan
AU - Molinari, Filippo
AU - Deandreis, Désirée
N1 - Publisher Copyright:
© 2022 Society of Nuclear Medicine Inc.. All rights reserved.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Aim: To evaluate the prognostic value of somatostatin receptor tumor burden (SRTB) at 68Ga-DOTATOC positron emission tomography/computed tomography (PET/CT) in patients with well-differentiated neuroendocrine tumors (WD-NETs). Methods: We retrospectively analyzed 68Ga-DOTATOC-PET/CT of 84 patients with histologically confirmed WD-NETs (51 G1, 30 G2 and 3 G3). For each PET/CT, all DOTATOC-avid lesions were independently segmented by 2 operators using a customized threshold based on the healthy liver maximum standardized uptake value (SUVmax) using LIFEx 5.1. Somatostatin receptor expressing tumor volume (SRETV) and total lesion somatostatin receptor expression (TLSRE=SRETV*SUVmean) were extracted for each lesion and then whole-body SRETV and TLSRE (SRETVwb and TLSREwb) were defined as the sum of SRETV and TLSRE of all segmented lesions in each patient, respectively. Time to progression (TTP) was defined as the combination of disease-free-survival in patients undergoing curative surgery (n=10) and progression-free survival for patients with unresectable/metastatic disease (n=74). TTP and overall survival (OS) were calculated by Kaplan-Meier analysis, log-rank test, and Cox’s proportional hazard model. Results: After a median follow-up period of 15.5 months disease progression was confirmed in 35 patients (41.7%) and 14 patients died. Higher SRETVwb (>39.1ml) and TLSREwb (>306.8g) were significantly correlated with shorter median TTP (TTP=12months vs not reached; p<0.001). In multivariate analysis, SRETVwb (p=0.005) was the only independent predictor of TTP regardless of histopathologic grade and TNM staging. Conclusion: According to our results, SRETVwb and TLSREwb extracted from 68Ga-DOTATOC-PET/CT could predict TTP/OS and might have an important clinical utility in the management of in patients with WD-NETs.
AB - Aim: To evaluate the prognostic value of somatostatin receptor tumor burden (SRTB) at 68Ga-DOTATOC positron emission tomography/computed tomography (PET/CT) in patients with well-differentiated neuroendocrine tumors (WD-NETs). Methods: We retrospectively analyzed 68Ga-DOTATOC-PET/CT of 84 patients with histologically confirmed WD-NETs (51 G1, 30 G2 and 3 G3). For each PET/CT, all DOTATOC-avid lesions were independently segmented by 2 operators using a customized threshold based on the healthy liver maximum standardized uptake value (SUVmax) using LIFEx 5.1. Somatostatin receptor expressing tumor volume (SRETV) and total lesion somatostatin receptor expression (TLSRE=SRETV*SUVmean) were extracted for each lesion and then whole-body SRETV and TLSRE (SRETVwb and TLSREwb) were defined as the sum of SRETV and TLSRE of all segmented lesions in each patient, respectively. Time to progression (TTP) was defined as the combination of disease-free-survival in patients undergoing curative surgery (n=10) and progression-free survival for patients with unresectable/metastatic disease (n=74). TTP and overall survival (OS) were calculated by Kaplan-Meier analysis, log-rank test, and Cox’s proportional hazard model. Results: After a median follow-up period of 15.5 months disease progression was confirmed in 35 patients (41.7%) and 14 patients died. Higher SRETVwb (>39.1ml) and TLSREwb (>306.8g) were significantly correlated with shorter median TTP (TTP=12months vs not reached; p<0.001). In multivariate analysis, SRETVwb (p=0.005) was the only independent predictor of TTP regardless of histopathologic grade and TNM staging. Conclusion: According to our results, SRETVwb and TLSREwb extracted from 68Ga-DOTATOC-PET/CT could predict TTP/OS and might have an important clinical utility in the management of in patients with WD-NETs.
KW - Ga-DOTATOC-PET/CT
KW - Neuroendocrine tumors
KW - prognosis
KW - somatostatin receptor expressing tumor volume
KW - total lesion somatostatin receptor expression
KW - Tumor burden
UR - http://www.scopus.com/inward/record.url?scp=85129314089&partnerID=8YFLogxK
U2 - 10.2967/jnumed.121.262652
DO - 10.2967/jnumed.121.262652
M3 - Article
C2 - 34740949
AN - SCOPUS:85129314089
SN - 0161-5505
VL - 63
SP - 1014
EP - 1020
JO - The Journal of nuclear medicine
JF - The Journal of nuclear medicine
IS - 7
ER -