Results of a Prospective Trial to Compare 68Ga-DOTA-TATE with SiPM-Based PET/CT vs. Conventional PET/CT in Patients with Neuroendocrine Tumors

Lucia Baratto, Akira Toriihara, Negin Hatami, Carina M Aparici, Guido Davidzon, Craig S Levin, Andrei Iagaru, Lucia Baratto, Akira Toriihara, Negin Hatami, Carina M Aparici, Guido Davidzon, Craig S Levin, Andrei Iagaru

Abstract

We prospectively enrolled patients with neuroendocrine tumors (NETs). They underwent a single 68Ga-DOTA-TATE injection followed by dual imaging and were randomly scanned using first either the conventional or the silicon photomultiplier (SiPM) positron emission tomography/computed tomography (PET/CT), followed by imaging using the other system. A total of 94 patients, 44 men and 50 women, between 35 and 91 years old (mean ± SD: 63 ± 11.2), were enrolled. Fifty-two out of ninety-four participants underwent SiPM PET/CT first and a total of 162 lesions were detected using both scanners. Forty-two out of ninety-four participants underwent conventional PET/CT first and a total of 108 lesions were detected using both scanners. Regardless of whether SiPM-based PET/CT was used first or second, maximum standardized uptake value (SUVmax) of lesions measured on SiPM was on average 20% higher when comparing two scanners with all enrolled patients, and the difference was statistically significant. SiPM-based PET/CT detected 19 more lesions in 13 patients compared with conventional PET/CT. No lesions were only identified by conventional PET/CT. In conclusion, we observed higher SUVmax for lesions measured from SiPM PET/CT compared with conventional PET/CT regardless of the order of the scans. SiPM PET/CT allowed for identification of more lesions than conventional PET/CT. While delayed imaging can lead to higher SUVmax in cancer lesions, in the series of lesions identified when SiPM PET/CT was used first, this was not the case; therefore, the data suggest superior performance of the SiPM PET/CT scanner in visualizing and quantifying lesions.

Keywords: 68Ga-DOTA-TATE PET; PET/CT; neuroendocrine tumor; silicon photomultiplier.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study population.
Figure 2
Figure 2
A 65-year-old woman with metastatic NET of unknown primary, referred for subsequent treatment strategy after chemotherapy. SiPM-based PET/CT was performed first at 72 min after injection of 4.2 mCi of 68Ga-DOTA-TATE. Conventional PET/CT was performed second at 96 min after injection. Red arrows mark an additional lesion seen in the dome of the liver only on SiPM-based PET/CT (A,B1), not on conventional PET/CT (B3,B4,E). Blue arrows mark bone lesions seen on conventional PET/CT (C3,C4,D3,D4,E) but more conspicuous on SiPM-based PET/CT (A,C1,C2,D1,D2).
Figure 3
Figure 3
A 59-year-old man with metastatic small bowel NET, referred for subsequent treatment strategy after small bowel resection. Conventional PET/CT was performed first at 85 min after injection of 4.5 mCi of 68Ga-DOTA-TATE. SiPM-based PET/CT was performed second at 110 min after injection. Red arrows mark an additional lesion seen in the right lobe of the liver only on SiPM-based PET/CT (B3,B4,E) not on conventional PET/CT (A,B1,B2). Blue arrows mark liver lesions seen on conventional PET/CT (A,C1,C2,D1,D2) but more conspicuous on SiPM-based PET/CT (C3,C4,D3,D4,E).

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