Additional Lesions Detected in Therapeutic Scans with Lu-177-DOTATATE Reflect Higher Affinity of Lu-177-DOTATATE for Somatostatin Receptors

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Abstract
Objective: Peptide receptor-targeted radionuclide therapy (PRRT) of somatostatin receptor (SR)-expressing neuroendocrine tumors (NETs) has become an established therapeutic option in patients with advanced NETs. The aim of this study was to compare the lesion detection rate of Tc-99m-EDDA/HYNIC-TOC, a newly developed tracer for NET imaging, with Lu-177-DOTATATE used for PRRT. Methods: 8 patients (4 women, 4 men, age range 46-76 years) with histologically proven NETs, who showed high SR loads by Tc-99m-EDDA/HYNIC-TOC scintigraphy, were treated with Lu-177-DOTATATE. After treatment, all patients were subjected to whole-body scintigraphy with additional low-dose single-photon emission computed tomography (SPECT-CT) of the chest and abdomen. Results: All patients demonstrated Lu-177-DOTATATE accumulation in all lesions previously detected by (99m)TcEDDA/ HYNIC-TOC scintigraphy. Three patients showed additional lesions in the liver and lungs. Conclusions: SPECT-CT after Lu-177-DOTATATE therapy may be helpful in detecting additional lesions not seen using Tc-99m-EDDA/HYNIC-TOC. This could reflect the broader affinity of Lu-177-DOTATATE for SRs compared with Tc-99m-EDDA/HYNIC-TOC. Copyright (C) 2011 S. Karger AG, Basel

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