Prognostic value of whole-body PET volumetric parameters extracted from68Ga-DOTATOC-PET/CT in well-differentiated neuroendocrine tumors in European Journal of Nuclear Medicine and Molecular Imaging
2021
AOU Città della Salute di Torino
Tipo pubblicazione
Conference Abstract
Autori/Collaboratori (11)Vedi tutti...
Thuillier P
Nuclear Medicine Unit, Department of Medical Sciences, University of Turin, Turin, Italy
Liberini V
Nuclear Medicine Unit, Department of Medical Sciences, University of Turin, Turin, Italy
Grimaldi S
Nuclear Medicine Unit, Department of Medical Sciences, University of Turin, Turin, Italy
et alii...
Abstract
Aim/Introduction: The objective of this study was to evaluate the prognostic value of somatostatin receptor tumor burden (SRTB) extracted from68Ga-DOTATOC PET/CT in patients presenting WD-NETs. Materials and Methods: We retrospectively analyzed PET/CT of 84 patients with histologically confirmed WD-NETs (51 G1, 30 G2 and 3 G3). Primary sites were as follows: gastroenteropancreatic (n=72), lung (n=9) and unknown (n=3) NETs. For each PET/CT, all DOTATOC-avid lesions were segmented by 2 operators using a customized threshold based on the healthy liver maximum standardize uptake value (SUVmax) to calculate the somatostatin receptor expressing tumor volume (SRETV) and total lesion somatostatin receptor expression (TLSRE=SRETV?SUVmean), using LIFEx 5.1. The sum of all lesions SRETV (SRETVwb) and TLSRE (TLSREwb) were calculated for each patient. Time to progression (TTP), defined as the time between PET imaging to the first event, and overall survival (OS) were studied using Kaplan- Meier analysis. Cox regression model was used to evaluate predictors of progression. Results: Progression was confirmed in 35 patients(41.7%) and 14 patients died (median followup 23 months). For SRTB parameters, optimal cut-offs for predicting progression were defined using the receiver operating characteristic (ROC) curve which revealed AUC of 0.83 and 0.79 for SRETVwb and TLSREwb, respectively. Higher SRETVwb (?39.1ml) and TLSREwb (>306.8g) were correlated with significantly shorter median TTP (TTP=12months vs not reached for both; p<0.001) and shorter median OS (OS not reached for both; p<0.001). SUVmax was not associated with TTP and OS (p=0.08 and p=0.09, respectively). TNM stage at PET time, Ki67% level, and treatment history were also significantly associated with a shorter TTP and OS (p<0.05), while age, gender and secretory syndrome were not associated with TTP and OS (p>0.05). In multivariate analysis using the Cox proportional regression model including only SRETVwb as SR
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DOI : 10.1007/s00259-021-05547-1
Keywords
endogenous compound; gallium 68; Ki 67 antigen; somatostatin receptor; adult; cancer size; cancer staging; clinical practice; cohort analysis; conference abstract; controlled study; disease free interval; female; follow up; gender; gene expression; histopathology; human; Kaplan Meier method; liver; lung; major clinical study; male; maximum standardized uptake value; neuroendocrine tumor; overall survival; positron emission tomography-computed tomography; prognosis; prospective study; protein expression; receiver operating characteristic; retrospective study; whole body PET;