Correlation between contrast enhancement, standardized uptake value (SUV), and diffusion restriction (ADC) with tumor grading in patients with therapy-naive neuroendocrine neoplasms using hybrid 68Ga-DOTATOC PET/MRI. Issue 137 (April 2021)

• Record Type: Journal Article
• Authors: Bruckmann, Nils Martin; Rischpler, Christoph; Kirchner, Julian; Umutlu, Lale; Herrmann, Ken; Ingenwerth, Marc; Theurer, Sarah; Lahner, Harald; Antoch, Gerald; Sawicki, Lino M.
• Is Part Of: European journal of radiology. Issue 137(2021)
• Publication Date: 2021-04
• Subjects: ADC apparent diffusion coefficient -- CT computed tomography -- CUP cancers of unknown primary -- DOTA 1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacedic acid -- DOTATOC DOTA-Phel-Tyr3-octreotide -- DWI diffusion-weighted imaging -- EPI echo-planar imaging -- EUS-FNA endoscopic ultrasound-guided fine-needle aspiration -- FWHM full-width at half maximum -- HASTE half fourier acquisition single shot turbo spin echo -- MRI magnetic resonance imaging -- NEC neuroendocrine carcinoma -- NEN neuroendocrine neoplasms -- NET neuroendocrine tumors -- OR odds ratio -- OSEM ordered-subset expectation maximization -- PET positron emission tomography -- ROI region of interest -- SSTR somatostatin receptor -- SUV standardized uptake value -- VIBE volume interpolated breath-hold examination -- VOI volume of interest -- WHO World Health Organization; PET/MRI -- Neuroendocrine neoplasms -- Imaging parameters -- Tumor grading; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2021.109588
• Languages: English
• ISSNs: 0720-048X

Abstract

Abstract: Objectives: To investigate a correlation between 68 Ga-DOTATOC PET/MR imaging parameters such as arterial and venous contrast enhancement, diffusion restriction, and maximum standardized uptake value (SUVmax) with histopathological tumor grading in patients with neuroendocrine neoplasms (NEN). Material and methods: A total of 26 patients with newly diagnosed, therapy-naive neuroendocrine neoplasms (NEN) were enrolled in this prospective study and underwent 68 Ga-DOTATOC PET/MRI. Images were evaluated regarding NEN lesion number and location, predominant tumor signal intensity on precontrast T1w and T2w images and on postcontrast arterial and portal venous phase T1w images, apparent diffusion coefficient (ADC) and SUVmax. Histopathological tumor grading was assessed and related to PET/MRI features using Pearson's correlation coefficient and Fisher's exact t -test. A binary logistic regression analysis was performed to evaluate a potential relation with an aggressive tumor biology and odds ratios (OR) were calculated. Results: There was a moderate negative correlation between arterial contrast enhancement and tumor grading (r=-0.35, p = 0.005), while portal venous enhancement showed a weak positive correlation with the Ki-67 index (r = 0.28, p = 0.008) and a non-significant positive correlation with tumor grading (r = 0.19, p = 0.063). Features that were significantly associated with an aggressive tumor biology were the presence of liver metastases (OR 2.6, p = 0.042), T1w hyperintensity in comparison to muscle (OR 12.7, p = 0.0001), arterial phase hyperenhancement (OR 1.4, p = 0.001), diffusion restriction (OR 2.8, p = 0.02) and SUVmax above the hepatic level (OR 7.0, p = 0.001). Conclusion: The study reveals that PET/MRI features might be useful for prediction of NEN grading and thus provide a preliminary assessment of tumor aggressiveness.