Dataset Information

Prospective comparison of [¹⁸F]AlF-NOTA-octreotide PET/MRI to [⁶⁸Ga]Ga-DOTATATE PET/CT in neuroendocrine tumor patients.

ABSTRACT:

Background

Fluorine-18-labeled SSAs have the potential to become the next-generation tracer in SSTR-imaging in neuroendocrine tumor (NET) patients given their logistical advantages over the current gold standard gallium-68-labeled SSAs. In particular, [¹⁸F]AlF-OC has already shown excellent clinical performance. We demonstrated in our previous report from our prospective multicenter trial that [¹⁸F]AlF-OC PET/CT outperforms [⁶⁸Ga]Ga-DOTA-SSA, but histological confirmation was lacking due to ethical and practical reasons. In this second arm, we therefore aimed to provide evidence that the vast majority of [¹⁸F]AlF-OC PET lesions are in fact true NET lesions by analyzing their MR characteristics on simultaneously acquired MRI. We had a special interest in lesions solely detected by [¹⁸F]AlF-OC ("incremental lesions").

Methods

Ten patients with a histologically confirmed neuroendocrine tumor (NET) and a standard-of-care [⁶⁸Ga]Ga-DOTATATE PET/CT, performed within 3 months, were prospectively included. Patients underwent a whole-body PET/MRI (TOF, 3 T, GE Signa), 2 hours after IV injection of 4 MBq/kg [¹⁸F]AlF-OC. Positive PET lesions were evaluated for a corresponding lesion on MRI. The diagnostic performance of both PET tracers was evaluated by determining the detection ratio (DR) for each scan and the differential detection ratio (DDR) per patient.

Results

In total, 195 unique lesions were detected: 167 with [⁶⁸Ga]Ga-DOTATATE and 193 with [¹⁸F]AlF-OC. The DR for [¹⁸F]AlF-OC was 99.1% versus 91.4% for [⁶⁸Ga]Ga-DOTATATE, significant for non-inferiority testing (p = 0.0001). Out of these 193 [¹⁸F]AlF-OC lesions, 96.2% were confirmed by MRI to be NET lesions. Thirty-three incremental lesions were identified by [¹⁸F]AlF-OC, of which 91% were confirmed by MRI and considered true positives.

Conclusion

The DR of [¹⁸F]AlF-OC was numerically higher and non-inferior to the DR of [⁶⁸Ga]Ga-DOTATATE. [¹⁸F]AlF-OC lesions and especially incremental lesions were confirmed as true positives by MRI in more than 90% of lesions. Taken together, these data further validate [¹⁸F]AlF-OC as a new alternative for SSTR PET in clinical practice. Trial registration ClinicalTrials.gov: NCT04552847. Registered 17 September 2020, https://beta.

Clinicaltrials

gov/study/NCT04552847.

SUBMITTER: Boeckxstaens L

PROVIDER: S-EPMC10235004 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Prospective comparison of [18F]AlF-NOTA-octreotide PET/MRI to [68Ga]Ga-DOTATATE PET/CT in neuroendocrine tumor patients.

Boeckxstaens Lennert L Pauwels Elin E Vandecaveye Vincent V Deckers Wies W Cleeren Frederik F Dekervel Jeroen J Vandamme Timon T Serdons Kim K Koole Michel M Bormans Guy G Laenen Annouschka A Clement Paul M PM Geboes Karen K Van Cutsem Eric E Nackaerts Kristiaan K Stroobants Sigrid S Verslype Chris C Van Laere Koen K Deroose Christophe M CM

EJNMMI research 20230601 1

<h4>Background</h4>Fluorine-18-labeled SSAs have the potential to become the next-generation tracer in SSTR-imaging in neuroendocrine tumor (NET) patients given their logistical advantages over the current gold standard gallium-68-labeled SSAs. In particular, [18F]AlF-OC has already shown excellent clinical performance. We demonstrated in our previous report from our prospective multicenter trial that [18F]AlF-OC PET/CT outperforms [68Ga]Ga-DOTA-SSA, but histolog ...[more]

PMID: 37261615

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