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Impact of initial imaging with gallium-68 dotatate PET/CT on diagnosis and management of patients with neuroendocrine tumors.

镓-68 dotatate PET/CT初始成像对神经内分泌肿瘤患者诊断和管理的影响。

  • 影响因子:2.88
  • DOI:10.1002/jso.25812
  • 作者列表:"Crown A","Rocha FG","Raghu P","Lin B","Funk G","Alseidi A","Hubka M","Rosales J","Lee M","Kennecke H
  • 发表时间:2020-03-01
Abstract

BACKGROUND:Somatostatin analog functional imaging with gallium-68 (Ga-68) dotatate positron emission tomography/computed tomography (PET/CT) has demonstrated superiority in lesion detection in patients with neuroendocrine tumors (NETs). The clinical impact of this imaging modality on US surgical and medical oncology practices has not been established. METHODS:Consecutive patients with NET at our institution who received an initial Ga-68 dotatate PET/CT between July 2017 and September 2018 were included. Ga-68 dotatate PET/CT was compared with prior imaging. RESULTS:Among 101 eligible patients, 51 of 50 were female/male, site of origin was gastroenteropancreatic (75%), unknown primary (13%), lung (8%), thymus (2%), and other (2%). All NETs were histologically well/moderately differentiated. Ga-68 dotatate imaging findings altered management in 36 (35.6%) patients: documentation of progression led to the initiation of systemic therapy in 14 patients, obviated the need for biopsy in four patients, and altered surgical plans in 7 of 14 (50%) patients referred for surgery. In 11 patients, decisions regarding peptide receptor radionucleotide therapy and somatostatin analogs were altered. CONCLUSIONS:In this series, Ga-68 dotatate PET/CT altered diagnosis and management in one-third of patients and changed operative plans in half of the patients who were referred for surgical evaluation. These results support the routine use of this imaging in the care of patients with early-stage and advanced NETs.

摘要

背景: 用镓-68 (Ga-68) dotatate正电子发射断层扫描/计算机断层扫描 (PET/CT) 进行的生长抑素类似物功能成像在神经内分泌肿瘤 (NETs) 患者的病灶检测中显示出优越性。这种成像方式对美国外科和医学肿瘤学实践的临床影响尚未确定。 方法: 纳入 2017 年 7 月至 2018 年 9 月在本机构接受初始Ga-68 dotatate PET/CT的连续NET患者。将Ga-68 dotatate PET/CT与先前成像进行比较。 结果: 在 101 例符合条件的患者中,50 例中 51 例为女性/男性,起源部位为胃肠胰 (75%),原发不明 (13%),肺 (8%),胸腺 (2%) 和其他 (2%)。所有NETs在组织学上良好/中度分化。Ga-68 dotatate影像学检查结果改变了 36 例 (35.6%) 患者的处理: 进展记录导致 14 例患者开始全身治疗,4 例患者无需活检,14 例患者中 7 例 (50%) 改变了手术计划。在 11 名患者中,关于肽受体放射性核苷酸治疗和生长抑素类似物的决定发生了改变。 结论: 在本系列研究中,Ga-68 dotatate PET/CT改变了 3分之1 患者的诊断和治疗,并改变了一半患者的手术计划。这些结果支持这种成像在早期和晚期NETs患者护理中的常规使用。

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影响因子:6.93
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DOI:10.1002/ijc.32530
作者列表:["Zhang L","Yang Y","Chai L","Bu H","Yang Y","Huang H","Ran J","Zhu Y","Li L","Chen F","Li W"]

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肺肿瘤方向

肺肿瘤,又叫支气管肺癌,是常见的恶性肿瘤之一。肺肿瘤的治疗为包括手术、中药、放疗、化疗及免疫等多学科的综合治疗。

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