Gallium-68 DOTATATE PET CT Frequently Changes Patient Management or Staging When Compared with Indium-111 Octreotide in the Assessment of Neuroendocrine Tumors Abstract #289

Introduction: 68Ga-DOTATATE PET CT offers higher resolution than previous octreotide-labelled scintigraphic techniques, and the literature suggests increased sensitivity for the localization and staging of NETs.
Aim(s): To explore the experience of comparative 68Ga-DOTATATE PET CT and 111In-Octreotide images in our institution.
Materials and methods: The records of all patients who underwent both 111In-Octreotide and 68Ga-DOTATATE PET CT within three months were examined (n=10). We examined whether management or staging had been altered by the information added by the 68Ga-DOTATATE PET CT. Additional information provided by standard imaging was noted.
Conference: 8th Annual ENETS Conference (2011)
Category: Clinical
Presenting Author: Dr Richard W Carroll

To read results and conclusion, please login ...

Further abstracts you may be interested in

#13 Neoadjuvant peptide receptor radionuclide therapy for an inoperable neuroendocrine pancreatic carcinoma
Introduction: Pancreatic endocrine tumors (pNETs) are rare but are among the most common neuroendocrine neoplasms of the abdomen. At diagnosis, many of them are already advanced and difficult to treat.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: Dr. Daniel Kaemmerer
#14 Radioguided surgery in NET: First impression with Ga-68 labeled somatostatin analogues
Introduction: Neuroendocrine tumors (NET) constitute a heterogenous group of neoplasms. The development of Gallium-68-labeled somatostatin analogues, such as DOTA-NOC or DOTA-TOC, PET/CT have dramatically improved the diagnosis of neuroendocrine tumors. Surgery remains the treatment of choice for localized disease as well as metastatic disease. The aims of surgery are: improvement of symptoms, reduction of tumor mass / burden and to give better quality of life to patients. Recurrent laparotomies often lead to multiple adhesions and altered anatomy. So it is increasingly difficult for imaging physicians and surgeons to separate non-malignant from malignant tissue.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: Dr. Daniel Kaemmerer
#18 Long-acting release octreotide induce complete response in type 1 gastric carcinoid tumors
Introduction: Gastric endocrine tumors (GET) are increasingly recognized due to expanding indications of upper gastrointestinal endoscopy. Often silent and benign, GET may also be aggressive when sporadic and may sometimes mimic the course of gastric adenocarcinoma. Current incidence of GETs is estimated at around 8% of digestive endocrine tumors. Yearly age-adjusted incidence is around 0.2 per population of 100,000. Gastric carcinoids (ECLomas) develop from gastric enterochromaffin-like cells (ECL cells) in response to chronically elevated gastrin. Type 1 tumors (ECLomas in the course of atrophic gastritis) may occur in conditions of achlorhydria secondary to auto-immune atrophic fundic gastritis. It occurs mostly in women and they are non-functioning tumors, typically found during upper GI endoscopy performed for dyspepsia. ECLomas present frequently as multiple polyps, usually < 1 cm in diameter in the gastric fundus. Type 1 tumors are almost exclusively benign lesions with little risk of deep invasion of the gastric parietal wall. The neoplastic ECL cells become progressively dedifferentiated with an increasing number of Ki-67 immunoreactive (IR) cell nuclei. In addition, there is a substantial decrease in argynophil and IR NE cells that can be visualized by conventional methods. ECLomas secondary to hypergastrinemia should be closely followed for signs of clinical and histopathological tumor progression. Such ECLomas deserve early, active, radical surgical treatment.
Traditionally, gastric carcinoid type 1 (GCA1s) are endoscopically or surgically removed, depending on the number, appearance and size of the tumors. Antrectomy, with surgical excision of the majority of the G cells, is thought to facilitate regression of these tumors by removing the source of excessive gastrin secretion; however, the long-term benefits of antrectomy still remain uncertain. Although proton pump inhibitors are effective in reducing hypergastrinemia-induced gastric acid hypersecretion in GCA2, they do not affect ECL-cell hyperplasia, and therefore their role in GCA1 is limited. Moreover, in selected cases, significant reduction of hypergastrinemia does not prevent development of ECL carcinoid, suggesting that, in addition to hypergastrinemia, other pathogenic or genetic factors may be involved. Treatment with somatostatin analogues (SSA) might impede ECL-cell hyperplasia by suppressing gastrin secretion and/or by a direct anti-proliferative effect on ECL cells. Treatment with SSAs in GCA1 leads to a substantial tumor load reduction, with a concomitant decrease of serum gastrin levels. Published data indicate an important anti-proliferative effect of SSA on ECL cells, providing clinical benefit and obviating, at least temporarily, the need for invasive therapies for GCA1. Morphometric studies demonstrated that, while antrectomy specifically decreased the volume of ECL cells versus the total volume of endocrine cells, octreotide reduces the overall endocrine cell volume. Although the number of treated patients is small, it has been suggested that SSA may exert important anti-proliferative effects either directly, by inhibiting ECL-cells proliferation, or indirectly through suppression of gastrin hypersecretion.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: MD Ricardo Caponero
#26 Molecular imaging of gastroenteropancreatic neuroendocrine tumours with Ga-68 DOTANOC PET/CT and correlation with an immunhistochemical quantification of somatostatin receptors using novel monoclonal and polyclonal antibodies
Introduction: Receptor PET/CT with somatostatin analogues marked with Gallium-68 (SMS-R-PET/CT) is currently the golden standard in diagnosing gastroenteropancreatic neuroendocrine tumors (GEP-NET), which are known for an overexpression of somatostatin receptors (SSTRs).
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: Dr Daniel Kaemmerer
#37 Gastric GIST with synchronous neuroendocrine tumor of the pancreas, Case Report and Literature Review
Introduction: The Gastrointestinal Stromal Tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. These are rare tumors with an incidence of 15 new cases per million per year. They often occur in individuals over the age of 40 years, without gender predominance. The clinical behavior is variable and benign tumors are the most common. They can develop anywhere in the GI tract, but are more frequent in the stomach and small intestine. The primary treatment, when located, is the surgical resection, which can be complemented with the use of imatinib.
The occurrence of neuroendocrine tumors of the pancreas is rare, representing 1-5% of pancreatic cancers, and it is estimated that its incidence does not exceed 5 to one million. The tumors considered nonfunctioning (15-32% of pancreatic neuroendocrine tumors) are not associated with any syndrome, and are usually incidental. They have a slight predominance in males, and are more frequent in the 6th decade of life. Nonfunctioning tumors of islet cells are virtually all malignant tumors, and the treatment consists of surgical resection.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: Dra Amelia B Tavares