Somatostatinrezeptor-PET/CT

C. Boy; T. Poeppel; J. Kotzerke; B. J. Krause; H. Amthauer; R. P. Baum; I. Buchmann; S. Ezziddin; D. Führer; M. Gabriel; T. Kuwert; H. Lahner; T. Lauenstein; H. R. Maecke; J. Nagarajah; F. Rösch; K. Scheidhauer; M. Schmidt; M. A. Walter; A. Bockisch

doi:10.1055/s-0038-1636560

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 2018; 57(01): 4-17
DOI: 10.1055/s-0038-1636560

DGN-Handlungsempfehlung (S1-Leitlinie)

Schattauer GmbH

Somatostatinrezeptor-PET/CT

Stand: 3/2017 – AWMF-Registernummer: 031–046Somatostatin receptor PET/CT (SSTR-PET/CT)

C. Boy

¹Klinik für Nuklearmedizin, Universitätsklinikum Essen

²Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum

,

T. Poeppel

¹Klinik für Nuklearmedizin, Universitätsklinikum Essen

,

J. Kotzerke

³Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Dresden

,

B. J. Krause

⁴Klinik und Poliklinik für Nuklearmedizin, Universitätsmedizin Rostock

,

H. Amthauer

⁵Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg, A.ö.R

,

R. P. Baum

⁶Klinik für Molekulare Radiotherapie, Zentrum für Molekulare Bildgebung, ENETS Center of Excellence, Zentralklinik Bad Berka

,

I. Buchmann

⁷Klinik für Radiologie und Nuklearmedizin, Campus Lübeck, Universitätsklinikum Schleswig-Holstein

,

S. Ezziddin

⁸Klinik für Nuklearmedizin, Universitätsklinikum des Saarlandes, Homburg

,

D. Führer

⁹Klinik für Endokrinologie und Stoffwechselerkrankungen, ENETS Center of Excellence, Universitätsklinikum Essen

,

M. Gabriel

¹⁰Universitätsklinik für Nuklearmedizin, Medizinische Universität Innsbruck, Österreich

¹¹Institut für Nuklearmedizin & Endokrinologie, Johannes Kepler Universität Linz, Österreich

,

T. Kuwert

¹²Klinik für Nuklearmedizin, Universitätsklinikum Erlangen

,

H. Lahner

⁹Klinik für Endokrinologie und Stoffwechselerkrankungen, ENETS Center of Excellence, Universitätsklinikum Essen

,

T. Lauenstein

¹³Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen

,

H. R. Maecke

¹⁴Klinik für Nuklearmedizin, Universitätsklinikum Freiburg

,

J. Nagarajah

¹Klinik für Nuklearmedizin, Universitätsklinikum Essen

¹⁵Memorial Sloan Kettering Cancer Center, New York, USA

,

F. Rösch

¹⁶Institut für Kernchemie, Johannes Gutenberg Universität Mainz

,

K. Scheidhauer

¹⁷Klinik für Nuklearmedizin, Klinikum rechts der Isar, Technische Universität München

,

M. Schmidt

¹⁸Klinik für Nuklearmedizin, Uniklinik Köln

,

M. A. Walter

¹⁹Klinik für Nuklearmedizin, Inselspital, Universitätsspital Bern

,

A. Bockisch

¹Klinik für Nuklearmedizin, Universitätsklinikum Essen

› Author Affiliations

Abstract

Zusammenfassung

Die vorliegende Handlungsempfehlung dient als Grundlage zur Qualitätssicherung der Somatostatinrezeptor (SSTR-) PET/CT bei onkologischen Patienten. Die Leitlinie wurde interdisziplinär erarbeitet und enthält neben der Definition und Zielsetzung einen Konsens hinsichtlich der erforderlichen klinischen Hintergrundinformationen, Indikationsstellung, Durchführung, Auswertung, Dokumentation und Befunderstellung. Dabei werden die beiden gebräuchlichsten Radiotracer der SSTRPET/ CT (68Ga-DOTATOC und 68Ga-DOTATATE) vertieft dargestellt. Die SSTR-PET/CT erfordert eine enge Interaktion zwischen den zuweisenden und ausführenden Fachdisziplinen unter Berücksichtigung bereits vorhandener Leitlinien und Handlungsempfehlungen europäischer und deutscher Fachgesellschaften, namentlich der European Association of Nuclear Medicine (EANM), der Deutschen Gesellschaft für Endokrinologie (DGE), Deutschen Gesellschaft für Nuklearmedizin (DGN) und Deutschen Röntgengesellschaft (DRG).

Summary

The present guideline is focused on quality assurance of somatostatin receptor PET/CT (SSTR-PET/CT) in oncology patients. The document has been developed by a multidisciplinary board of specialists providing consensus of definitions, prerequisites, methodology, operating procedures, assessment, and standardized reporting. In particular, imaging procedures for the two most commonly used radioligands of human SSTR, i. e. 68Ga-DOTATOC and 68Ga-DOTATATE are presented. Overall, SSTR-PET/CT requires close interdisciplinary communication and cooperation of referring and executing medical disciplines, taking into account existing guidelines and recommendations of the European and German medical societies, including the European Association of Nuclear Medicine (EANM), German Society for Endocrinology (DGE), German Society for Nuclear Medicine (DGN) and German Society for Radiology (DRG).

Schlüsselwörter

Leitlinie - DOTATOC - DOTATATE - PET/CT - Onkologie

Keywords

Somatostatin receptor PET/CT (SSTR-PET/CT)

Full Text

References

Literatur
1 Hoyer D, Bell GI, Berelowitz M, Epelbaum J, Feniuk W, Humphrey PP, O’Carroll AM, Patel YC, Schonbrunn A, Taylor JE. Classification and nomenclature of somatostatin receptors. Trends Pharmacol Sci 1995; 16: 86-8.
2 Patel YC. Somatostatin and its receptor family. Front Neuroendocrinol 1999; 20: 157-198.
3 Reubi JC. Somatostatin and other Peptide receptors as tools for tumor diagnosis and treatment. Neuroendocrinology 2004; 80 (Suppl. 01) 51-56.
4 Wild D, Mäcke HR, Waser B, Reubi JC, Ginj M, Rasch H, Müller-Brand J, Hofmann M. 68GaDOTANOC: a first compound for PET imaging with high affinity for somatostatin receptor subtypes 2 and 5. Eur J Nucl Med Mol Imaging 2005; 32: 724.
5 Boy C, Heusner TA, Poeppel TD, Redmann-Bischofs A, Unger N, Jentzen W, Brandau W, Mann K, Antoch G, Bockisch A, Petersenn S. 68Ga-DOTATOC PET/CT and somatostatin receptor (sst1-sst5) expression in normal human tissue: correlation of sst2 mRNA and SUVmax. Eur J Nucl Med Mol Imaging 2011; 38: 1224-1236.
6 Reubi JC, Schonbrunn A. Illuminating somatostatin analog action at neuroendocrine tumor receptors. Trends Pharmacol Sci 2013; 34: 676-688.
7 Reubi JC, Waser B, Cescato R, Gloor B, Stettler C, Christ E. Internalized somatostatin receptor subtype 2 in neuroendocrine tumors of Octreotidtreated patients. J Clin Endocrinol Metab 2010; 95: 2343-2350.
8 Reubi JC, Waser B, Schaer JC, Laissue JA. Somatostatin receptor sst1-sst5 expression in normal and neoplastic human tissues using receptor autoradiography with subtype-selective ligands. Eur J Nucl Med 2001; 28: 836-846.
9 Gabriel M, Decristoforo C, Kendler D, Dobrozemsky G, Heute D, Uprimny C, Kovacs P, Von Guggenberg E, Bale R, Virgolini IJ. 68Ga-DOTATyr3-Octreotid PET in neuroendocrine tumors: comparison with somatostatin receptor scintigraphy and CT. J Nucl Med 2007; 48: 508-518.
10 Gabriel M, Oberauer A, Dobrozemsky G, Decristoforo C, Putzer D, Kendler D, Uprimny C, Kovacs P, Bale R, Virgolini IJ. 68Ga-DOTA-Tyr3-Octreotid PET for assessing response to somatostatin-receptor-mediated radionuclide therapy. J Nucl Med 2009; 50: 1427-1434.
11 Hartmann H, Zophel K, Freudenberg R, Oehme L, Andreeff M, Wunderlich G, Eisenhofer G, Kotzerke J. Radiation exposure of patients during 68Ga-DOTATOC PET/CT examinations. Nuklearmedizin 2009; 48: 201-7.
12 Oberg KE, Reubi JC, Kwekkeboom DJ, Krenning EP. Role of somatostatins in gastroenteropancreatic neuroendocrine tumor development and therapy. Gastroenterology 2010; 139: 742-753 753.e1..
13 Shastry M, Kayani I, Wild D, Caplin M, Visvikis D, Gacinovic S, Reubi JC, Bomanji JB. Distribution pattern of 68Ga-DOTATATE in disease-free patients. Nucl Med Commun 2010; 31: 1025-32.
14 Velikyan I, Sundin A, Eriksson B, Lundqvist H, Sorensen J, Bergstrom M, Langstrom B. In vivo binding of [68Ga]-DOTATOC to somatostatin receptors in neuroendocrine tumours – impact of peptide mass. Nucl Med Biol 2010; 37: 265-275.
15 Breeman WA, de Blois E, Sze HChan, Konijnenberg M, Kwekkeboom DJ, Krenning EP. (68)Ga-labeled DOTA-peptides and (68)Ga-labeled radiopharmaceuticals for positron emission tomography: current status of research, clinical applications, and future perspectives. Semin Nucl Med 2011; 41: 314-321.
16 Maecke HR, Reubi JC. Somatostatin receptors as targets for nuclear medicine imaging and radionuclide treatment. J Nucl Med 2011; 52: 841-844.
17 Poeppel TD, Binse I, Petersenn S, Lahner H, Schott M, Antoch G, Brandau W, Bockisch A, Boy C. 68Ga-DOTATOC versus 68Ga-DOTATATE PET/ CT in functional imaging of neuroendocrine tumors. J Nucl Med 2011; 52: 1864-1870.
18 Treglia G, Castaldi P, Rindi G, Giordano A, Rufini V. Diagnostic performance of Gallium-68 somatostatin receptor PET and PET/CT in patients with thoracic and gastroenteropancreatic neuroendocrine tumours: a meta-analysis. Endocrine 2012; 42: 80-87.
19 Kunikowska J, Krolicki L, Pawlak D, Zerizer I, Mikolajczak R. Semiquantitative analysis and characterization of physiological biodistribution of (68)Ga-DOTA-TATE PET/CT. Clin Nucl Med 2012; 37: 1052-1057.
20 Kroiss A, Putzer D, Decristoforo C, Uprimny C, Warwitz B, Nilica B, Gabriel M, Kendler D, Waitz D, Widmann G, Virgolini IJ. 68Ga-DOTA-TOC uptake in neuroendocrine tumour and healthy tissue: differentiation of physiological uptake and pathological processes in PET/CT. Eur J Nucl Med Mol Imaging 2013; 40: 514-523.
21 Kuyumcu S, Ozkan ZG, Sanli Y, Yilmaz E, Mudun A, Adalet I, Unal S. Physiological and tumoral uptake of (68)Ga-DOTATATE: standardized uptake values and challenges in interpretation. Ann Nucl Med 2013; 27: 538-545.
22 Johnbeck CB, Knigge U, Kjaer A. PET tracers for somatostatin receptor imaging of neuroendocrine tumors: current status and review of the literature. Future Oncol 2014; 10: 2259-2277.
23 Poeppel TD, Boy C, Bockisch A, Kotzerke J, Buchmann I, Ezziddin S, Scheidhauer K, Krause BJ, Schmidt D, Amthauer H, Rosch F, Nagarajah J, Fuhrer D, Lahner H, Popperl G, Horsch D, Walter MA, Baum RP. Peptide receptor radionuclide therapy for patients with somatostatin receptor expressing tumours. German Guideline (S1). Nuklearmedizin 2015; 54: 1-11.
24 Theodoropoulou M, Stalla GK. Somatostatin receptors: from signaling to clinical practice. Front Neuroendocrinol 2013; 34: 228-252.
25 Ruf J, Schiefer J, Kropf S, Furth C, Ulrich G, Kosiek O, Denecke T, Pavel M, Pascher A, Wiedenmann B, Amthauer H. Quantification in Ga-DOTA(0)Phe(1)-Tyr(3)-Octreotid positron emission tomography/computed tomography: can we be impartial about partial volume effects?. Neuroendocrinology 2013; 97: 369-374.
26 Sandstrom M, Velikyan I, Garske-Roman U, Sorensen J, Eriksson B, Granberg D, Lundqvist H, Sundin A, Lubberink M. Comparative biodistribution and radiation dosimetry of 68Ga-DOTATOC and 68Ga-DOTATATE in patients with neuroendocrine tumors. J Nucl Med 2013; 54: 1755-1759.
27 Velikyan I, Sundin A, Sorensen J, Lubberink M, Sandstrom M, Garske-Roman U, Lundqvist H, Granberg D, Eriksson B. Quantitative and quail tative intrapatient comparison of 68Ga-DOTATOC and 68Ga-DOTATATE: net uptake rate for accurate quantification. J Nucl Med 2014; 55: 204-210.
28 Reubi JC, Schar JC, Waser B, Wenger S, Heppeler A, Schmitt JS, Macke HR. Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med 2000; 27: 273-282.
29 Eckelman WC. The application of receptor theory to receptor-binding and enzyme-binding oncologic radiopharmaceuticals. Nucl Med Biol 1994; 21: 759-769.
30 Baum RP, Kulkarni HR. THERANOSTICS: From Molecular Imaging Using Ga-68 Labeled Tracers and PET/CT to Personalized Radionuclide Therapy - The Bad Berka Experience. Theranostics 2012; 02: 437-447.
31 Bodei L, Mueller-Brand J, Baum RP, Pavel ME, Horsch D, O'Dorisio MS, O'Dorisio TM, Howe JR, Cremonesi M, Kwekkeboom DJ, Zaknun JJ. The joint IAEA, EANM, and SNMMI practical guidance on peptide receptor radionuclide therapy (PRRNT) in neuroendocrine tumours. Eur J Nucl Med Mol Imaging 2013; 40: 800-816.
32 Boellaard R, Delgado-Bolton R, Oyen WJ, Giammarile F, Tatsch K, Eschner W, Verzijlbergen FJ, Barrington SF, Pike LC, Weber WA, Stroobants S, Delbeke D, Donohoe KJ, Holbrook S, Graham MM, Testanera G, Hoekstra OS, Zijlstra J, Visser E, Hoekstra CJ, Pruim J, Willemsen A, Arends B, Kotzerke J, Bockisch A, Beyer T, Chiti A, Krause BJ. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging 2015; 42: 328-354.
33 Radojewski PL, Dumont R, Marincek N, Brunner P, Mäcke HR, Müller-Brand J, Briel M, Walter MA. Towards tailored radiopeptide therapy. Eur J Nucl Med Mol Imaging 2015; 42: 1231-1237.
34 Bombardieri E, Ambrosini V, Aktolun C, Baum RP, Bishof-Delaloye A, Del Vecchio S, Maffioli L, Mortelmans L, Oyen W, Pepe G, Chiti A. Oncology Committee of the EANM. 111In-pentetreotide scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging 2010; 37: 1441-1448.
35 Brogsitter C, Zophel K, Hartmann H, Schottelius M, Wester HJ, Kotzerke J. Twins in spirit part II: DOTATATE and high-affinity DOTATATE--the clinical experience. Eur J Nucl Med Mol Imaging 2014; 41: 1158-1165.
36 Krause BJ, Beyer T, Bockisch A, Delbeke D, Kotzerke J, Minkov V, Reiser M, Willich N. FDG-PET/ CT in oncology. German Guideline. Nuklearmedizin 2007; 46: 291-301.
37 Waser B, Tamma ML, Cescato R, Maecke HR, Reubi JC. Highly efficient in vivo agonist-induced internalization of sst2 receptors in somatostatin target tissues. J Nucl Med 2009; 50: 936-941.
38 Walker RC, Smith GT, Liu E, Moore B, Clanton J, Stabin M. Measured human dosimetry of 68Ga- DOTATATE. J Nucl Med 2013; 54: 855-860.
39 Virgolini I, Ambrosini V, Bomanji JB, Baum RP, Fanti S, Gabriel M, Papathanasiou ND, Pepe G, Oyen W, De Cristoforo C, Chiti A. Procedure guidelines for PET/CT tumour imaging with 68Ga-DOTA-conjugated peptides: 68Ga-DOTATOC, 68Ga-DOTA-NOC, 68Ga-DOTA-TATE. Eur J Nucl Med Mol Imaging 2010; 37: 2004-2010.
40 Society of Radiology (ESR). Good practice for radiological reporting. Guidelines from the European Society of Radiology (ESR). Insights Imaging 2011; 02: 93-96.
41 Elsinga P, Todde S, Penuelas I, Meyer G, Farstad B, Faivre-Chauvet A, Mikolajczak R, Westera G, Gmeiner-Stopar T, Decristoforo C. Radiopharmacy Committee of the EANM. Guidance on current good radiopharmacy practice (cGRPP) for the small-scale preparation of radiopharmaceuticals. Eur J Nucl Med Mol Imaging 2010; 37: 1049-1062.
42 Aerts J, Ballinger JR, Behe M, Decristoforo C, Elsinga PH, Faivre-Chauvet A, Mindt TL, Kolenc PPeitl, Todde SC, Koziorowski J. Guidance on current good radiopharmacy practice for the smallscale preparation of radiopharmaceuticals using automated modules: a European perspective. J Labelled Comp Radiopharm 2014; 57: 615-620.