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Somatostatin receptor imaging with [18F]FET-bAG-TOCA PET/CT and [68Ga]Ga-DOTA-peptide PET/CT in patients with neuroendocrine tumors: a prospective, phase 2 comparative study
Dubash, S. Barwick, T. D. Kozlowski, K. Rockall, A. G. Khan, S. Khan, S. Yusuf, S. Lamarca, Angela Valle, John W
Dubash, S.
Barwick, T. D.
Kozlowski, K.
Rockall, A. G.
Khan, S.
Khan, S.
Yusuf, S.
Lamarca, Angela
Valle, John W
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Abstract
There is a clinical need for 18F -labeled somatostatin analogs for the imaging of neuroendocrine tumors (NET), given the limitations of using [68Ga]Ga-DOTA-peptides, particularly with regard to widespread accessibility. We have shown that [18F]fluoroethyl-triazole-[Tyr3]- octreotate ([18F]FET-beta AG-TOCA) has favorable dosimetry and biodistribution. As a step toward clinical implementation, we conducted a prospective, noninferiority study of [18F]FET-beta AG-TOCA PET/CT compared with [68Ga]Ga-DOTA- peptide PET/CT in patients with NET. Methods: Forty-five patients with histologically confirmed NET, grades 1 and 2, underwent PET/CT imaging with both [18F]FET-beta AG-TOCA and [68Ga]Ga-peptide performed within a 6-mo window (median, 77 d; range, 6-180 d). Whole -body PET/CT was conducted 50 min after injection of 165 MBq of [18F]FET-beta AG-TOCA. Tracer uptake was evaluated by comparing SUVmax and tumor -tobackground ratios at both lesion and regional levels by 2 unblinded, experienced readers. A randomized, blinded reading of both scans was also then undertaken by 3 experienced readers, and consensus was assessed at a regional level. The ability of both tracers to visualize liver metastases was also assessed. Results: A total of 285 lesions were detected on both imaging modalities. An additional 13 tumor deposits were seen in 8 patients on [18F]FET-beta AG-TOCA PET/CT, and [68Ga]Ga-DOTA-peptide PET/CT detected an additional 7 lesions in 5 patients. Excellent correlation in SUVmax was observed between both tracers (r = 0.91; P < 0.001). No difference was observed between median SUVmax across regions, except in the liver, where the median tumor -to -background ratio of [18F]FET-beta AG-TOCA was significantly lower than that of [68Ga]Ga-DOTA-peptide (2.5 +/- 1.9 vs. 3.5 +/- 2.3; P < 0.001). Conclusion: [18F]FET-beta AG-TOCA was not inferior to [68Ga]Ga-DOTA-peptide in visualizing NET and may be considered in routine clinical practice given the longer half-life and availability of the cyclotron -produced fluorine radioisotope.
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2024
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Dubash S, Barwick TD, Kozlowski K, Rockall AG, Khan S, Khan S, et al. Somatostatin Receptor Imaging with [18F]FET-βAG-TOCA PET/CT and [68Ga]Ga-DOTA-Peptide PET/CT in Patients with Neuroendocrine Tumors: A Prospective, Phase 2 Comparative Study. JOURNAL OF NUCLEAR MEDICINE. 2024 MAR 1;65(3):416-22. PubMed PMID: WOS:001207604300013. English.