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Nuklearmedizin 2016; 55(03): 104-114
DOI: 10.3413/Nukmed-0742-15-05
Original article
Schattauer GmbH

Dynamic 68Ga-DOTATOC PET/CT and static image in NET patients

Correlation of parameters during PRRTDynamische und statische 68Ga-DOTATOC-PET/CT bei Patienten mit NETKorrelation der Parameter während der PRRT
Sofie Van Binnebeek
1   Nuclear Medicine, University Hospitals Leuven and Department of Imaging & Pathology, KU Leuven
,
Michel Koole
1   Nuclear Medicine, University Hospitals Leuven and Department of Imaging & Pathology, KU Leuven
,
Christelle Terwinghe
1   Nuclear Medicine, University Hospitals Leuven and Department of Imaging & Pathology, KU Leuven
,
Kristof Baete
1   Nuclear Medicine, University Hospitals Leuven and Department of Imaging & Pathology, KU Leuven
,
Bert Vanbilloen
1   Nuclear Medicine, University Hospitals Leuven and Department of Imaging & Pathology, KU Leuven
,
Karine Haustermans
2   Radiation Oncology, University Hospitals Leuven and Department of Oncology, KU Leuven
,
Paul M. Clement
3   General Medical Oncology, University Hospitals Leuven and Department of Oncology, KU Leuven
,
Kris Bogaerts
4   Department of Public Health and primary Care (I-BioStat), KU Leuven
,
Alfons Verbruggen
5   Laboratory for Radiopharmacy, KU Leuven
,
Kris Nackaerts
6   Pulmonology, University Hospitals Leuven
,
Eric Van Cutsem
7   Division of Digestive Oncology, University Hospitals Leuven and Department of Oncology, KU Leuven
,
Chris Verslype
7   Division of Digestive Oncology, University Hospitals Leuven and Department of Oncology, KU Leuven
,
Felix M. Mottaghy
8   Department of Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
9   Department of Nuclear Medicine, University Hospital Aachen, Germany
,
Christophe M. Deroose
1   Nuclear Medicine, University Hospitals Leuven and Department of Imaging & Pathology, KU Leuven
› Author Affiliations
Further Information

Publication History

received: 21 May 2015

accepted in revised form: 12 January 2016

Publication Date:
06 March 2018 (online)

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Summary

Purpose: To investigate the relationship between the dynamic parameters (Ki) and static image-derived parameters of 68Ga-DOTATOC-PET, to determine which static parameter best reflects underlying somatostatin-receptor-expression (SSR) levels on neuroendocrine tumours (NETs). Patients, methods: 20 patients with metastasized NETs underwent a dynamic and static 68Ga-DOTATOC-PET before PRRT and at 7 and 40 weeks after the first administration of 90Y-DOTATOC (in total 4 cycles were planned); 175 lesions were defined and analyzed on the dynamic as well as static scans. Quantitative analysis was performed using the software PMOD. One to five target lesions per patient were chosen and delineated manually on the baseline dynamic scan and further, on the corresponding static 68Ga-DOTATOC-PET and the dynamic and static 68Ga-DOTATOC-PET at the other time-points; SUVmax and SUVmean of the lesions was assessed on the other six scans. The input function was retrieved from the abdominal aorta on the images. Further on, Ki was calculated using the Patlak-Plot. At last, 5 reference regions for normalization of SUVtumour were delineated on the static scans resulting in 5 ratios (SUVratio). Results: SUVmax and SUVmean of the tumoural lesions on the dynamic 68Ga-DO-TATOC-PET had a very strong correlation with the corresponding parameters in the static scan (R²: 0.94 and 0.95 respectively). SUVmax, SUVmean and Ki of the lesions showed a good linear correlation; the SUVratios correlated poorly with Ki. A significantly better correlation was noticed between Ki and SUVtumour(max and mean) (p < 0.0001). Conclusions: As the dynamic para meter Ki correlates best with the absolute SUVtumour, SUVtumour best reflects underlying SSR-levels in NETs.

Zusammenfassung

Das Ziel der Studie war das Verhältnis zwischen dem dynamischen Parameter (Ki) und statischen Parametern der 68Ga-DOTATOC-PET zu untersuchen und den statischen Parameter zu definieren, der am besten mit der Somatostatinrezeptor (SSR) Expression von neuroendokrinen Tumoren (NET) korreliert. Patienten und Methoden: 20 Patienten mit metastasierten NET erhielten eine dynamische und statische 68Ga-DOTATOC-PET vor der ersten PRRT und 7 und 40 Wochen nach der ersten Administration von 90Y-DOTATOC (insgesamt wurden 4 Zyklen geplant); 175 Läsionen wurden auf den statischen und dynamischen Bildern definiert und ausgewertet. Die quantitative Analyse wurde mit der Software PMOD durchgeführt. Eine bis fünf Zielläsionen wurden pro Patient im ersten dynamischen Scan ausgewählt, mit einer VOI versehen, welche dann auf die weiteren dynamischen und statischen Scans transferiert wurde; sowohl SUVmax als auch SUVmean wurden bestimmt. Die Input Funktion wurde aus der im Field-of-view liegenden Aorta generiert. Ki wurde mit Hilfe des Patlak-Plots berechnet. Zuletzt wurden 5 Referenzregionen für die Normalisation des SUVtumo auf den statischen Scans bestimmt, zur Bestimmung von 5 Verhältnissen (SUVratio). Ergebnisse: SUVmax und SUVmean der Tumorläsionen inden dynamischen 68Ga-DOTATOC-PET zeigten eine sehr starke Korrelation mit den entsprechenden Parametern in den statischen Scans (R²: 0,94 bzw. 0,95). SUVmax, SUVmean und Ki der Läsionen zeigte eine gute lineare Korrelation; die verschiedenen SUVratios korrelierten auf sehr niedrigem Niveau mit Ki. Eine signifikant bessere Korrelation zeigte sich zwischen Ki und SUVtumour(max and mean) (p < 0.0001). Schlussfolgerung: Der dynamische Parameter Ki korreliert am besten mit dem absoluten SUVtumour. SUVtumour reflektiert am besten den Level der SSR-Expression in NET.

Keywords

68Ga-DOTATOC PET - Ki - somatostatin receptor expression - PRRT - neuroendocrine tumour

Schlüsselwörter

68Ga-DOTATOC PET - Ki - Somatostatinrezeptor-Expression - PRRT - neuroendokriner Tumor
 

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