Head-to-head comparison between 18 F-DOPA PET/CT and 68 Ga-DOTA peptides PET/CT in detecting intestinal neuroendocrine tumours: A systematic review and meta-analysis

Arnoldo Piccardo; Francesco Fiz; Gianluca Bottoni; Martina Ugolini; Walter Noordzij; Pierpaolo Trimboli

doi:10.1111/cen.14527

Head-to-head comparison between ¹⁸ F-DOPA PET/CT and ⁶⁸ Ga-DOTA peptides PET/CT in detecting intestinal neuroendocrine tumours: A systematic review and meta-analysis

Clin Endocrinol (Oxf). 2021 Oct;95(4):595-605. doi: 10.1111/cen.14527. Epub 2021 Jun 19.

Authors

Arnoldo Piccardo¹, Francesco Fiz^{1

2}, Gianluca Bottoni¹, Martina Ugolini¹, Walter Noordzij³, Pierpaolo Trimboli^{4

5}

Affiliations

¹ Nuclear Medicine Department, Ente Ospedaliero "Ospedali Galliera", Genoa, Italy.
² Department of Nuclear Medicine, IRCCS-Humanitas Research Hospital, Rozzano, Italy.
³ Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
⁴ Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland.
⁵ Clinic of Endocrinology and Diabetology, Lugano and Mendrisio Regional Hospital, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.

PMID: 34018606
DOI: 10.1111/cen.14527

Abstract

Purpose: The imaging of intestinal neuroendocrine tumours (NETs) relies on functional positron emission tomography (PET) tracers; these tumours can be studied by means of both ⁶⁸ Ga-DOTA peptides and ¹⁸ F-fluorodihydroxyphenyl- l-alanine (¹⁸ F-DOPA) PET/computed tomography (CT). As yet, it is unclear which of these two modalities offers the better sensitivity. We therefore conducted a meta-analysis to assess the available data.

Methods: PubMed, CENTRAL, Scopus and Web of Science were searched for studies comparing the sensitivity of ⁶⁸ Ga-DOTA peptides and ¹⁸ F-DOPA PET/CT; papers up to February 2021 were considered. In each study, we considered sensitivity in terms of patient-based analysis (PBA), region-based analysis (RBA) and lesion-based analysis (LBA), and pooled the results yielded by each tracer. Multidisciplinary follow-up served as the standard of truth.

Results: Of the 636 records identified, 6 articles published between 2008 and 2021 were finally selected, and 112 intestinal NETs patients were included. The pooled sensitivity of ¹⁸ F-DOPA PET/CT was 83%, 89% and 95% on PBA, RBA and LBA, respectively. ⁶⁸ Ga-DOTA peptides PET/CT showed sensitivity of 88%, 92% and 82% on PBA, RBA and LBA, respectively. No significant differences were found between the two tracers on PBA and RBA. By contrast, a clear trend towards significance in favour of ¹⁸ F-DOPA PET/CT was identified on LBA. The presence of a significant difference in favour of ¹⁸ F-DOPA PET/CT was confirmed in a subgroup analysis conducted only on the most recent and largest studies. In all three analyses, mild-to-high heterogeneity was found; however, no publication bias was observed.

Conclusion: Both ¹⁸ F-DOPA PET/CT and ⁶⁸ Ga-DOTA-peptides PET/CT are reliable diagnostic procedures in patients with intestinal NETs. However, in terms of lesion detection, a non-negligible difference in favour of ¹⁸ F-DOPA PET/CT was observed. Thus, the use of ¹⁸ F-DOPA PET/CT could be considered as a first-line molecular procedure in intestinal NETs.

Keywords: 18F-DOPA; 68Ga-DOTA; PET/CT; meta-analysis; neuroendocrine.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Dihydroxyphenylalanine
Humans
Neuroendocrine Tumors* / diagnostic imaging
Organometallic Compounds*
Peptides
Positron Emission Tomography Computed Tomography
Positron-Emission Tomography

Substances

Organometallic Compounds
Peptides
Dihydroxyphenylalanine