Prospective Multicentric Assessment of ⁶⁸Ga-DOTANOC PET/CT in Grade 1-2 GEP-NET

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) require accurate staging and monitoring.
• Conventional imaging (CI) includes somatostatin receptor scintigraphy (SRS) with SPECT/CT, CT, and MRI.
• Limitations of CI in detecting GEP-NET recurrence and metastases exist.

Purpose of the Study:

• To prospectively compare 68Ga-DOTANOC PET/CT with conventional imaging (CI) for GEP-NETs.
• To evaluate the diagnostic performance of 68Ga-DOTANOC PET/CT in detecting GEP-NET recurrence and metastases.
• To assess the impact of 68Ga-DOTANOC PET/CT on therapeutic management.

Main Methods:

• Multicenter prospective study comparing 68Ga-DOTANOC PET/CT and CI (SRS, CT, MRI).
• Inclusion of 105 patients with histologically proven grade 1-2 GEP-NET.
• Histology and imaging follow-up served as the gold standard.

Main Results:

• 68Ga-DOTANOC PET/CT showed significantly higher sensitivity than CI (98.9% vs. 88.6% per patient; 97.6% vs. 75.6% per region).
• Superior detection rates for primary tumors, peritoneal carcinomatosis, and bone metastases were observed with 68Ga-DOTANOC PET/CT.
• Therapeutic management was impacted in 41.9% of patients following 68Ga-DOTANOC PET/CT.

Conclusions:

• 68Ga-DOTANOC PET/CT is superior to conventional imaging for GEP-NET detection.
• The study confirms the enhanced ability of 68Ga-DOTANOC PET/CT in identifying peritoneal carcinomatosis and bone metastases.
• 68Ga-DOTANOC PET/CT demonstrates a significant therapeutic impact on patient management for GEP-NETs.