64Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with 111In-DTPA-Octreotide in 112 Patients

Andreas Pfeifer; Ulrich Knigge; Tina Binderup; Jann Mortensen; Peter Oturai; Annika Loft; Anne Kiil Berthelsen; Seppo W Langer; Palle Rasmussen; Dennis Elema; Eric von Benzon; Liselotte Højgaard; Andreas Kjaer

doi:10.2967/jnumed.115.156539

64Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with 111In-DTPA-Octreotide in 112 Patients

Andreas Pfeifer, Ulrich Knigge, Tina Binderup, Jann Mortensen, Peter Oturai, Annika Loft, Anne Kiil Berthelsen, Seppo W Langer, Palle Rasmussen, Dennis Elema, Eric von Benzon, Liselotte Højgaard, Andreas Kjaer

55 Citations (Scopus)

Abstract

Neuroendocrine tumors (NETs) can be visualized using radiolabeled somatostatin analogs. We have previously shown the clinical potential of ⁶⁴Cu-DOTATATE in a small first-in-human feasibility study. The aim of the present study was, in a larger prospective design, to compare on a head-to-head basis the performance of ⁶⁴Cu-DOTATATE and ¹¹¹In-diethylenetriaminepentaacetic acid (DTPA)-octreotide (¹¹¹In-DTPA-OC) as a basis for implementing ⁶⁴Cu-DOTATATE as a routine. Methods: We prospectively enrolled 112 patients with pathologically confirmed NETs of gastroenteropancreatic or pulmonary origin. All patients underwent both PET/CT with ⁶⁴Cu-DOTATATE and SPECT/CT with ¹¹¹In-DTPA-OC within 60 d. PET scans were acquired 1 h after injection of 202 MBq (range, 183-232 MBq) of ⁶⁴Cu-DOTATATE after a diagnostic contrast-enhanced CT scan. Patients were followed for 42-60 mo for evaluation of discrepant imaging findings. The McNemar test was used to compare the diagnostic performance. Results: Eightyseven patients were congruently PET-and SPECT-positive. No SPECT-positive cases were PET-negative, whereas 10 false-negative SPECT cases were identified using PET. The diagnostic sensitivity and accuracy of ⁶⁴Cu-DOTATATE (97% for both) were significantly better than those of ¹¹¹In-DTPA-OC (87% and 88%, respectively, P 5 0.017). In 84 patients (75%), ⁶⁴Cu-DOTATATE identified more lesions than ¹¹¹In-DTPA-OC and always at least as many. In total, twice as many lesions were detected with ⁶⁴Cu-DOTATATE than with ¹¹¹In-DTPA-OC. Moreover, in 40 of 112 cases (36%) lesions were detected by ⁶⁴Cu-DOTATATE in organs not identified as disease-involved by ¹¹¹In-DTPA-OC. Conclusion: With these results, we demonstrate that ⁶⁴Cu-DOTATATE is far superior to ¹¹¹In-DTPAOC in diagnostic performance in NET patients. Therefore, we do not hesitate to recommend implementation of ⁶⁴Cu-DOTATATE as a replacement for ¹¹¹In-DTPA-OC.

Original language	English
Journal	Journal of Nuclear Medicine
Volume	56
Issue number	6
Pages (from-to)	847-54
Number of pages	8
ISSN	0161-5505
DOIs	https://doi.org/10.2967/jnumed.115.156539
Publication status	Published - 1 Jun 2015

Keywords

Adult
Aged
Aged, 80 and over
Biopsy
Female
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Multimodal Imaging
Neoplasm Metastasis
Neuroendocrine Tumors
Octreotide
Organometallic Compounds
Pentetic Acid
Positron-Emission Tomography
Prospective Studies
Receptors, Somatostatin
Stomach Neoplasms
Tomography, Emission-Computed, Single-Photon
Tomography, X-Ray Computed

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.2967/jnumed.115.156539

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Pfeifer, A., Knigge, U., Binderup, T., Mortensen, J., Oturai, P., Loft, A., Berthelsen, A. K., Langer, S. W., Rasmussen, P., Elema, D., von Benzon, E., Højgaard, L., & Kjaer, A. (2015). 64Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with 111In-DTPA-Octreotide in 112 Patients. Journal of Nuclear Medicine, 56(6), 847-54. https://doi.org/10.2967/jnumed.115.156539

Pfeifer, A, Knigge, U , Binderup, T , Mortensen, J, Oturai, P, Loft, A, Berthelsen, AK, Langer, SW, Rasmussen, P, Elema, D, von Benzon, E, Højgaard, L & Kjaer, A 2015, '64Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with 111In-DTPA-Octreotide in 112 Patients', Journal of Nuclear Medicine, vol. 56, no. 6, pp. 847-54. https://doi.org/10.2967/jnumed.115.156539

@article{9c975885f0394477ae47364b6cba7f3f,

title = "64Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with 111In-DTPA-Octreotide in 112 Patients",

abstract = "Neuroendocrine tumors (NETs) can be visualized using radiolabeled somatostatin analogs. We have previously shown the clinical potential of 64Cu-DOTATATE in a small first-in-human feasibility study. The aim of the present study was, in a larger prospective design, to compare on a head-to-head basis the performance of 64Cu-DOTATATE and 111In-diethylenetriaminepentaacetic acid (DTPA)-octreotide (111In-DTPA-OC) as a basis for implementing 64Cu-DOTATATE as a routine. Methods: We prospectively enrolled 112 patients with pathologically confirmed NETs of gastroenteropancreatic or pulmonary origin. All patients underwent both PET/CT with 64Cu-DOTATATE and SPECT/CT with 111In-DTPA-OC within 60 d. PET scans were acquired 1 h after injection of 202 MBq (range, 183-232 MBq) of 64Cu-DOTATATE after a diagnostic contrast-enhanced CT scan. Patients were followed for 42-60 mo for evaluation of discrepant imaging findings. The McNemar test was used to compare the diagnostic performance. Results: Eightyseven patients were congruently PET-and SPECT-positive. No SPECT-positive cases were PET-negative, whereas 10 false-negative SPECT cases were identified using PET. The diagnostic sensitivity and accuracy of 64Cu-DOTATATE (97% for both) were significantly better than those of 111In-DTPA-OC (87% and 88%, respectively, P 5 0.017). In 84 patients (75%), 64Cu-DOTATATE identified more lesions than 111In-DTPA-OC and always at least as many. In total, twice as many lesions were detected with 64Cu-DOTATATE than with 111In-DTPA-OC. Moreover, in 40 of 112 cases (36%) lesions were detected by 64Cu-DOTATATE in organs not identified as disease-involved by 111In-DTPA-OC. Conclusion: With these results, we demonstrate that 64Cu-DOTATATE is far superior to 111In-DTPAOC in diagnostic performance in NET patients. Therefore, we do not hesitate to recommend implementation of 64Cu-DOTATATE as a replacement for 111In-DTPA-OC.",

keywords = "Adult, Aged, Aged, 80 and over, Biopsy, Female, Humans, Image Processing, Computer-Assisted, Male, Middle Aged, Multimodal Imaging, Neoplasm Metastasis, Neuroendocrine Tumors, Octreotide, Organometallic Compounds, Pentetic Acid, Positron-Emission Tomography, Prospective Studies, Receptors, Somatostatin, Stomach Neoplasms, Tomography, Emission-Computed, Single-Photon, Tomography, X-Ray Computed",

author = "Andreas Pfeifer and Ulrich Knigge and Tina Binderup and Jann Mortensen and Peter Oturai and Annika Loft and Berthelsen, {Anne Kiil} and Langer, {Seppo W} and Palle Rasmussen and Dennis Elema and {von Benzon}, Eric and Liselotte H{\o}jgaard and Andreas Kjaer",

note = "{\textcopyright} 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.",

year = "2015",

month = jun,

day = "1",

doi = "10.2967/jnumed.115.156539",

language = "English",

volume = "56",

pages = "847--54",

journal = "The Journal of Nuclear Medicine",

issn = "0161-5505",

publisher = "Society of Nuclear Medicine",

number = "6",

}

TY - JOUR

T1 - 64Cu-DOTATATE PET for Neuroendocrine Tumors

T2 - A Prospective Head-to-Head Comparison with 111In-DTPA-Octreotide in 112 Patients

AU - Pfeifer, Andreas

AU - Knigge, Ulrich

AU - Binderup, Tina

AU - Mortensen, Jann

AU - Oturai, Peter

AU - Loft, Annika

AU - Berthelsen, Anne Kiil

AU - Langer, Seppo W

AU - Rasmussen, Palle

AU - Elema, Dennis

AU - von Benzon, Eric

AU - Højgaard, Liselotte

AU - Kjaer, Andreas

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Neuroendocrine tumors (NETs) can be visualized using radiolabeled somatostatin analogs. We have previously shown the clinical potential of 64Cu-DOTATATE in a small first-in-human feasibility study. The aim of the present study was, in a larger prospective design, to compare on a head-to-head basis the performance of 64Cu-DOTATATE and 111In-diethylenetriaminepentaacetic acid (DTPA)-octreotide (111In-DTPA-OC) as a basis for implementing 64Cu-DOTATATE as a routine. Methods: We prospectively enrolled 112 patients with pathologically confirmed NETs of gastroenteropancreatic or pulmonary origin. All patients underwent both PET/CT with 64Cu-DOTATATE and SPECT/CT with 111In-DTPA-OC within 60 d. PET scans were acquired 1 h after injection of 202 MBq (range, 183-232 MBq) of 64Cu-DOTATATE after a diagnostic contrast-enhanced CT scan. Patients were followed for 42-60 mo for evaluation of discrepant imaging findings. The McNemar test was used to compare the diagnostic performance. Results: Eightyseven patients were congruently PET-and SPECT-positive. No SPECT-positive cases were PET-negative, whereas 10 false-negative SPECT cases were identified using PET. The diagnostic sensitivity and accuracy of 64Cu-DOTATATE (97% for both) were significantly better than those of 111In-DTPA-OC (87% and 88%, respectively, P 5 0.017). In 84 patients (75%), 64Cu-DOTATATE identified more lesions than 111In-DTPA-OC and always at least as many. In total, twice as many lesions were detected with 64Cu-DOTATATE than with 111In-DTPA-OC. Moreover, in 40 of 112 cases (36%) lesions were detected by 64Cu-DOTATATE in organs not identified as disease-involved by 111In-DTPA-OC. Conclusion: With these results, we demonstrate that 64Cu-DOTATATE is far superior to 111In-DTPAOC in diagnostic performance in NET patients. Therefore, we do not hesitate to recommend implementation of 64Cu-DOTATATE as a replacement for 111In-DTPA-OC.

AB - Neuroendocrine tumors (NETs) can be visualized using radiolabeled somatostatin analogs. We have previously shown the clinical potential of 64Cu-DOTATATE in a small first-in-human feasibility study. The aim of the present study was, in a larger prospective design, to compare on a head-to-head basis the performance of 64Cu-DOTATATE and 111In-diethylenetriaminepentaacetic acid (DTPA)-octreotide (111In-DTPA-OC) as a basis for implementing 64Cu-DOTATATE as a routine. Methods: We prospectively enrolled 112 patients with pathologically confirmed NETs of gastroenteropancreatic or pulmonary origin. All patients underwent both PET/CT with 64Cu-DOTATATE and SPECT/CT with 111In-DTPA-OC within 60 d. PET scans were acquired 1 h after injection of 202 MBq (range, 183-232 MBq) of 64Cu-DOTATATE after a diagnostic contrast-enhanced CT scan. Patients were followed for 42-60 mo for evaluation of discrepant imaging findings. The McNemar test was used to compare the diagnostic performance. Results: Eightyseven patients were congruently PET-and SPECT-positive. No SPECT-positive cases were PET-negative, whereas 10 false-negative SPECT cases were identified using PET. The diagnostic sensitivity and accuracy of 64Cu-DOTATATE (97% for both) were significantly better than those of 111In-DTPA-OC (87% and 88%, respectively, P 5 0.017). In 84 patients (75%), 64Cu-DOTATATE identified more lesions than 111In-DTPA-OC and always at least as many. In total, twice as many lesions were detected with 64Cu-DOTATATE than with 111In-DTPA-OC. Moreover, in 40 of 112 cases (36%) lesions were detected by 64Cu-DOTATATE in organs not identified as disease-involved by 111In-DTPA-OC. Conclusion: With these results, we demonstrate that 64Cu-DOTATATE is far superior to 111In-DTPAOC in diagnostic performance in NET patients. Therefore, we do not hesitate to recommend implementation of 64Cu-DOTATATE as a replacement for 111In-DTPA-OC.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Biopsy

KW - Female

KW - Humans

KW - Image Processing, Computer-Assisted

KW - Male

KW - Middle Aged

KW - Multimodal Imaging

KW - Neoplasm Metastasis

KW - Neuroendocrine Tumors

KW - Octreotide

KW - Organometallic Compounds

KW - Pentetic Acid

KW - Positron-Emission Tomography

KW - Prospective Studies

KW - Receptors, Somatostatin

KW - Stomach Neoplasms

KW - Tomography, Emission-Computed, Single-Photon

KW - Tomography, X-Ray Computed

U2 - 10.2967/jnumed.115.156539

DO - 10.2967/jnumed.115.156539

M3 - Journal article

C2 - 25952736

SN - 0161-5505

VL - 56

SP - 847

EP - 854

JO - The Journal of Nuclear Medicine

JF - The Journal of Nuclear Medicine

IS - 6

ER -

64Cu-DOTATATE PET for Neuroendocrine Tumors: A Prospective Head-to-Head Comparison with 111In-DTPA-Octreotide in 112 Patients

Abstract

Keywords

UN SDGs

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