Detection of Bone Metastases by 68Ga-DOTA-SSAs and 18F-FDG PET/CT: A Two-Center Head-to-Head Study of Gastroenteropancreatic Neuroendocrine Neoplasms

Rui Tian; Qing Xie; Fei Yu; Changzhi Du; Xiaochen Yao; Shiming Zang; Chuan Zhang; Pengjun Zhang; Guoqiang Shao; Zhi Yang; Feng Wang; Jiangyuan Yu

doi:10.1155/2022/1750132

Detection of Bone Metastases by ⁶⁸Ga-DOTA-SSAs and ¹⁸F-FDG PET/CT: A Two-Center Head-to-Head Study of Gastroenteropancreatic Neuroendocrine Neoplasms

Contrast Media Mol Imaging. 2022 Nov 7:2022:1750132. doi: 10.1155/2022/1750132. eCollection 2022.

Authors

Rui Tian¹, Qing Xie², Fei Yu¹, Changzhi Du², Xiaochen Yao¹, Shiming Zang¹, Chuan Zhang¹, Pengjun Zhang¹, Guoqiang Shao¹, Zhi Yang², Feng Wang¹, Jiangyuan Yu²

Affiliations

¹ Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
² Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital and Institute, Beijing 100142, China.

Abstract

Purpose: This study aimed to assess the efficacy of dual-tracer [⁶⁸Ga-DOTA-somatostatin receptor analogs (SSAs) and ¹⁸F-fluorodeoxyglucose (FDG)] positron emission tomography/computed tomography (PET/CT) imaging for detecting bone metastases (BMs) in patients with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs).

Methods: We retrospectively enrolled 74 GEP-NEN patients with BMs from two centers, who underwent dual-tracer PET/CT from January 2014 to March 2021. We compared and analyzed effectiveness of the dual PET/CT imaging techniques on the BMs, based on ¹⁸F-FDG and ⁶⁸Ga-DOTA-SSAs. Specifically, we analyzed the imaging results using χ ² tests for classification variables, paired-sample tests for number of BMs, Wilcoxon's signed rank test for number of lesions, and the Kruskal-Wallis test for standard uptake value (SUV) ratio comparison. The correlation of dual-tracer SUVmax with Ki-67 index was analyzed by Spearman's correlation coefficient.

Results: The detection efficiencies of dual-tracer PET/CT imaging in patients with different pathologies showed discordant for detecting liver metastases and BMs in group neuroendocrine tumor (NET) G3, ⁶⁸Ga-DOTA-SSAs was better at detecting BMs for NET G3 (P=0.049 for SUV_T/B and P=0.026 for the number of metastatic lesions). In addition, statistical significance was found among osteogenesis group, osteolysis group, and the no-change group (for bone SUV_T/B value detected by ¹⁸F-FDG and Ki-67 index, osteogenesis group < osteolysis group; for bone SUV_T/B detected by ⁶⁸Ga-DOTA-SSAs, osteogenesis group > the no-change group). What is more, liver and bone SUVmax and Ki-67 index were positively correlated in ¹⁸F-FDG imaging (P < 0.001 for liver; P=0.002 for bone), and negatively correlated in ⁶⁸Ga-DOTA-SSAs imaging (P < 0.001 for liver; P=0.039 for bone).

Conclusions: ⁶⁸Ga-DOTA-SSAs was superior to ¹⁸F-FDG for detecting BMs in NET G1/G2 (well and moderately differentiated NETs), as well as in NET G3 (poorly differentiated NETs). Relatively good differentiation was observed in the osteogenesis group. In addition, dual-tracer PET/CT imaging results were observably correlated with tumor differentiation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Bone Neoplasms*
Fluorodeoxyglucose F18
Gallium Radioisotopes
Gastrointestinal Neoplasms*
Humans
Ki-67 Antigen
Neuroendocrine Tumors* / diagnostic imaging
Osteolysis*
Positron Emission Tomography Computed Tomography
Receptors, Somatostatin
Retrospective Studies

Substances

Fluorodeoxyglucose F18
Receptors, Somatostatin
Gallium Radioisotopes
1,4,7,10-tetraazacyclododecane- 1,4,7,10-tetraacetic acid
Ki-67 Antigen