Nuklearmedizin 2019; 58(02): 194-195
DOI: 10.1055/s-0039-1683742
Poster
Theranostik
Georg Thieme Verlag KG Stuttgart · New York

Prognostic value of F-18-FDG PET/CT in a large cohort of 495 patients with advanced neuroendocrine neoplasms (NEN) treated with peptide receptor radionuclide therapy (PRRT)

J Zhang
1   Zentralklinik Bad Berka, THERANOSTICS Center for Molecular Radiotherapy & Molecular Imaging, Bad Berka
,
HR Kulkarni
1   Zentralklinik Bad Berka, THERANOSTICS Center for Molecular Radiotherapy & Molecular Imaging, Bad Berka
,
A Singh
1   Zentralklinik Bad Berka, THERANOSTICS Center for Molecular Radiotherapy & Molecular Imaging, Bad Berka
,
K Niepsch
1   Zentralklinik Bad Berka, THERANOSTICS Center for Molecular Radiotherapy & Molecular Imaging, Bad Berka
,
RP Baum
1   Zentralklinik Bad Berka, THERANOSTICS Center for Molecular Radiotherapy & Molecular Imaging, Bad Berka
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
27. März 2019 (online)

Auch verfügbar auf
 

Ziel/Aim:

The aim of this study was to evaluate the role of F-18-FDG PET/CT in a large cohort of 495 patients with advanced neuroendocrine neoplasms (NEN) who were treated with Peptide receptor radionuclide therapy (PRRT) and long-term follow-up.

Methodik/Methods:

495 patients (M = 299 males; age range 25 – 79 y, mean age 59.0 ± 10.7 y) received PRRT with Lu-177 and/or Y-90 labeled somatostatin analogs (DOTATATE or DOTATOC), and all patients received both Ga-68-SSTR PET/CT and F-18-FDG PET/CT at the baseline before PRRT. Kaplan-Meier analysis, log-rank test (Mantel-Cox), and Cox regression analysis were performed for survival analysis.

Ergebnisse/Results:

199 patients (66.7%) presented with pancreatic NEN, 49 (15.9%) with CUP, 139 with midgut NEN, whereas the primary tumor was present in the rectum in 20, in the lung in 38, in the stomach in 8, and others in 42 patients. The median follow-up was 94 months (range 3 – 189 months). For all patients, the median PFS was 19.6 months and the median OS was 59.4 months. The median OS of patients with pancreatic, midgut and bronchopulmonary NEN were 54.4 months, 77.8 months and 46.2 months, respectively. For patients with F-18-FDG PET-positive (n = 382), the median PFS was 18.5 months and median OS 53.2 months. Patients with F-18-FDG PET-negative (n = 113), had a median PFS of 24.1 months and a median OS of 83.1 months. A significant difference was found for both, PFS and OS, as p = 0.0015 and p 2, the median OS was 53.0 months, comparing with 43.4 months in those patients with the ratio < 2 (p = 0.0296). For those patients with no F-18-FDG uptake, the median OS were 108.3 vs. 76.9 months for a SUVmax > 15.0 and a SUVmax < 15.0 on SSTR-PET, respectively. In the pancreatic NENs subgroup (n = 199), the median OS was 114.3 months in F-18-FDG-negative group and 52.8 months in F-18-FDG PET-positive group (p = 0.0006).

Schlussfolgerungen/Conclusions:

F-18-FDG PET/CT is an independent prognostic factor in patients with NEN treated with PRRT. High uptake on SSTR PET/CT combined with negative F-18-FDG PET/CT is also associated with a better long-term prognosis.