Journal article
68 Ga-DOTATOC Imaging of Neuroendocrine Tumors: A Systematic Review and Metaanalysis
The Journal of nuclear medicine (1978), Vol.58(9), pp.1452-1458
09/2017
DOI: 10.2967/jnumed.117.191197
PMCID: PMC6944175
PMID: 28280220
Abstract
Ga-DOTATOC, a somatostatin receptor-targeted ligand, has been used clinically in Europe over the past decade for imaging neuroendocrine tumors (NETs). It appears to be quite sensitive and effective for clinical management decision making. This metaanalysis summarizes the efficacy of
Ga-DOTATOC for several distinct indications and is intended to support approval of this agent by the U.S. Food and Drug Administration.
The major electronic medical databases were searched for relevant papers over the period from January 2001 to November 2015. Papers were selected for review in 3 categories: clinical trials that reported sensitivity and specificity, comparison studies with
In-octreotide, and change of management studies. All the eligible papers underwent Quality Assessment of Diagnostic Accuracy Studies (QUADAS) assessment, which was useful in the final selection of papers for review.
The initial search yielded 468 papers. After detailed evaluation, 17 papers were finally selected. Five types of studies emerged: workup of patients with symptoms and biomarker findings suggestive of NET, but with negative conventional imaging (3 papers, yield was only 13%); sensitivity (12 papers; sensitivity, 92%) and specificity (7 papers; specificity, 82%); identification of site of unknown primary in patients with metastatic NET (4 papers, yield was 44%); impact on subsequent NET patient management (4 papers, change in management in 51%); and comparison with
In-octreotide (2 papers, sensitivity of DOTATOC on a per-lesion basis was 100%, for
In-octreotide it was 78.2%; specificity was not available). Safety was not explicitly addressed in any study, but there were no reports of adverse events.
Ga-DOTATOC is useful for evaluating the presence and extent in disease for staging and restaging and for assisting in treatment decision making for patients with NET. It is also effective in locating the site of an unknown primary in NET patients who present with metastatic NET, but no known primary tumor. It also appears to be more accurate than
In-octreotide. Although
Ga-DOTATOC would seem to be useful in evaluating patients with suggestive symptoms and biomarker findings, it does not perform well in this setting and has low yield. Overall, it appears to be an excellent imaging agent to assess patients with known NET and frequently leads to a change in management.
Details
- Title: Subtitle
- 68 Ga-DOTATOC Imaging of Neuroendocrine Tumors: A Systematic Review and Metaanalysis
- Creators
- Michael M Graham - Division of Nuclear Medicine, Department of Radiology, University of Iowa, Iowa City, Iowa michael-graham@uiowa.eduXiaomei Gu - Hardin Library for the Health Sciences, University of Iowa, Iowa City, Iowa; andTimothy Ginader - Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IowaPatrick Breheny - Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IowaJohn J Sunderland - Division of Nuclear Medicine, Department of Radiology, University of Iowa, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of nuclear medicine (1978), Vol.58(9), pp.1452-1458
- DOI
- 10.2967/jnumed.117.191197
- PMID
- 28280220
- PMCID
- PMC6944175
- NLM abbreviation
- J Nucl Med
- ISSN
- 2159-662X
- eISSN
- 1535-5667
- Publisher
- United States
- Grant note
- P30 CA086862 / NCI NIH HHS P50 CA174521 / NCI NIH HHS
- Language
- English
- Date published
- 09/2017
- Academic Unit
- Radiology; Biostatistics; Physics and Astronomy; Radiation Oncology
- Record Identifier
- 9983997440802771
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