Multicenter Comparison of 18F-FDG and 68Ga-DOTA-Peptide PET/CT for Pulmonary Carcinoid. (March 2015)

• Record Type: Journal Article
• Authors: Lococo, Filippo; Perotti, Germano; Cardillo, Giuseppe; De Waure, Chiara; Filice, Angelina; Graziano, Paolo; Rossi, Giulio; Sgarbi, Giorgio; Stefanelli, Antonella; Giordano, Alessandro; Granone, Pierluigi; Rindi, Guido; Versari, Annibale; Rufini, Vittoria
• Is Part Of: Clinical nuclear medicine. Volume 40:Number 3(2015)
• Publication Date: 2015-03
• Subjects: Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000000641
• Languages: English
• ISSNs: 0363-9762

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Purpose</title> <p>The aims of this study were to retrospectively evaluate and compare the detection rate (DR) of <sup>68</sup>Ga-DOTA-peptide and <sup>18</sup>F-FDG PET/CT in the preoperative workup of patients with pulmonary carcinoid (PC) and to assess the utility of various functional indices obtained with the 2 tracers in predicting the histological characterization of PC, that is, typical versus atypical.</p> </sec> <sec> <title>Methods</title> <p>Thirty-three consecutive patients with confirmed PC referred for <sup>18</sup>F-FDG and <sup>68</sup>Ga-DOTA-peptide PET/CT in 2 centers between January 2009 and April 2013 were included. The semiquantitative evaluation included the SUV<sub>max</sub>, the SUV of the tumor relative to the maximal liver uptake for <sup>18</sup>F-FDG (SUV<sub>T/L</sub>) or the maximal spleen uptake for <sup>68</sup>Ga-DOTA-peptides (SUV<sub>T/S</sub>), the ratio between SUV<sub>max</sub> of <sup>68</sup>Ga-DOTA-peptides PET/CT, and the SUV<sub>max</sub> of <sup>18</sup>F-FDG PET/CT (SUV<sub>max</sub> ratio). Histology was used as reference standard.</p> </sec> <sec> <title>Results</title> <p>Definitive diagnosis consisted of 23 typical carcinoids (TCs) and 10 atypical carcinoids. <sup>18</sup>F-FDG PET/CT was positive in 18 cases and negative in 15 (55% DR). <sup>68</sup>Ga-DOTA-peptide PET/CT was positive in 26 cases and negative in 7 (79% DR). In the subgroup analysis, <sup>68</sup>Ga-DOTA-peptide PET/CT was superior in detecting TC (91% DR; <italic>P</italic> < 0.001), whereas <sup>18</sup>F-FDG PET/CT was superior in detecting atypical carcinoid (100% DR; <italic>P</italic> = 0.04). The SUV<sub>max</sub> ratio was the most accurate semiquantitative index in identifying TC.</p> </sec> <sec> <title>Conclusions</title> <p>Overall diagnostic performance of PET/CT in detecting PC is optimal when integrating <sup>18</sup>F-FDG and <sup>68</sup>Ga-DOTA-peptide PET/CT findings. In the subgroup analysis, the SUV<sub>max</sub> ratio seems to be the most accurate index in predicting TC. Both methods should be performed when PC is suspected or when the histological subtype is undefined.</p> </sec> </abstract>