Functional imaging of neuroendocrine tumors with combined PET/CT using 68Ga‐DOTATATE (DOTA‐DPhe1,Tyr3‐octreotate) and 18F‐FDG

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Abstract
BACKGROUND. The aim was to assess the relevant distribution of the novel PET tracer 68Ga‐DOTATATE in neuroendocrine tumors (NETs) with combined positron emission tomography / computed tomography (PET/CT) and compare its performance with that of 18F‐FDG PET/CT. METHODS. The imaging findings with 68Ga‐DOTATATE and 18F‐FDG on 38 consecutive patients with a diagnosis of primary or recurrent NET were compared and correlated with tumor grade on histology based on ki67 and mitotic index. RESULTS. The sensitivity of 68Ga‐DOTATATE PET/CT was 82% (31 of 38) and that of 18F‐FDG PET/CT was 66% (25 of 38). The sensitivity of combined 68Ga‐DOTATATE and 18F‐FDG PET/CT was 92% (35 of 38). There was greater uptake of 68Ga‐DOTATATE than 18F‐FDG in low‐grade NET (median SUV 29 vs 2.9, P < .001). In high‐grade NET there was higher uptake of 18F‐FDG over 68Ga‐DOTATATE (median SUV 11.7 vs 4.4, P = .03). There was a significant correlation with predominant tumor uptake of 68Ga‐DOTATATE or 18F‐FDG and tumor grade on histology (P < .0001). CONCLUSIONS. 68Ga‐DOTATATE PET/CT is a useful novel imaging modality for NETs and is superior to 18F‐FDG for imaging well‐differentiated NET. Functional imaging with both 68Ga‐DOTATATE and 18F‐FDG has potential for a more comprehensive tumor assessment in intermediate‐ and high‐grade tumors. Cancer 2008. ©2008 American Cancer Society.