Diagnostic Accuracy of Gallium-68-DOTATATE PET/CT Compared to Indium-111-pentetreotide Scintigraphy (SPECT/CT) for Gastroenteropancreatic Neuroendocrine Tumors
Ontology highlight
ABSTRACT:
DISEASE(S): Neuroendocrine Tumors,Gastroenteropancreatic Neuroendocrine Tumors,Pancreatic Neoplasms,Stomach Neoplasms,Intestinal Neoplasms
PROVIDER: 2162039 | ecrin-mdr-crc |
REPOSITORIES: ECRIN MDR
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Project description:Interventions: Group 1: Therapy companion imaging is performed in patients with neuroendocrine tumors treated by Lutetium-177 DOTATATE. Organ doses were calculated using image data. Beside, the standard protocol defined by SPECT/CT and five whole body scintigraphies (nominally at 4h, 24h, 48h, 72h and 168h p.i.), patients were examined by additionally imaging procedures. These procedures will be performed by using a modern cadmium-zinc-tellurite (CZT)-detector technology. An additional SPECT scan ist performed in companion to the SPECT/CT examination with a standard system. Furthermore, an additional whole body scintigraphy is performed at 48h p.i. by using the CZT-based system.
Primary outcome(s): Comparison in detection rate of focal lesions by two different SPECT/CT-systems for (1.) scintigraphy and (2.) SPECT/CT in Lutetium-177-DOTATATE therapy
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Project description:Somatostatin receptors are overexpressed in GEP-NETs and can be visualized in vivo by radiolabeled somatostatin-analogs.
During the last decades, conventional scintigraphy using 111In-DTPA-Octreotide (often named somatostatin receptor scintigraphy or SRS) was considered as the gold standard nuclear imaging technique in the evaluation of GEP-NETs. However, SRS may be suboptimal in this clinical setting because of the low intrinsic resolution of the technique and its selectivity for SST2 only. Its overall sensitivity is estimated to 60-70% (per lesion analysis), even when using the most recent SPECT-CT cameras. MRI have also a higher sensitivity than CT and SRS for the detection of liver metastases from GEP-NETs.
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[68Ga]-DOTANOC which also binds to SST5 was recently found to detect significantly more lesions than the SST2-specific radiotracer [68Ga]-DOTATATE in patients with GEP-NETs but this requires further evaluation.
It is therefore important to determine the interest of [68Ga]-DOTANOC combined with the standard diagnosis strategy in GEP-NETs and evaluate medicoeconomic impact of adding [68Ga]-DOTANOC in the work-up of patients.
The investigators hypothesis is that [68Ga]-DOTANOC will modify the management in at least 20% of patients in a more adapted way according to the 2012 ENETS guidelines in comparison to the decision based on the standard imaging work up (multiphasic WB CT, liver MRI and SRS).
110 patients will be included prospectively in 5 different French experienced centers (Marseille, Bordeaux, Toulouse, Paris, Clermond-Ferrand).
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