Neuroendocrine Neoplasms: Total-body PET/Computed Tomography

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• Neuroendocrine neoplasms (NENs) require accurate diagnostic and staging tools.
• Gallium-68 DOTATATE (⁶⁸Ga DOTATATE) and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) are established imaging modalities.

Purpose of the Study:

• To evaluate the routine use of low-dose ⁶⁸Ga DOTATATE and 18F-FDG PET/CT (static and dynamic) in patients with NENs.
• To assess the complementary roles of these agents in diagnosis, staging, and therapy response.
• To explore the utility of dynamic PET/CT parameters for understanding tumor biology and differential diagnosis.

Main Methods:

• Utilized total-body PET/CT (uExplorer) for both static and dynamic imaging.
• Administered low-dose ⁶⁸Ga DOTATATE (48.1–73.6 MBq).
• Combined with either low-dose (1.55 MBq/kg) or ultra-low-dose (0.37 MBq/kg) 18F-FDG.

Main Results:

• ⁶⁸Ga DOTATATE and 18F-FDG PET/CT static imaging demonstrated complementary roles in NEN diagnosis, staging, and evaluating therapy response.
• Dynamic scan parameters, including kinetic parameters and time-activity curves, provided valuable information about tumor biological characteristics.
• Dynamic imaging aided in the differential diagnosis of NENs.

Conclusions:

• Routine use of low-dose ⁶⁸Ga DOTATATE and 18F-FDG PET/CT is effective for NEN management.
• Static imaging with both tracers is crucial for comprehensive assessment.
• Dynamic PET/CT analysis enhances understanding of NEN behavior and aids in diagnosis.