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Ga-68-DOTATATE Compared with In-111-DTPA-Octreotide and Conventional Imaging for Pulmonary and Gastroenteropancreatic Neuroendocrine Tumors: A Systematic Review and Meta-Analysis
Journal article   Open access   Peer reviewed

Ga-68-DOTATATE Compared with In-111-DTPA-Octreotide and Conventional Imaging for Pulmonary and Gastroenteropancreatic Neuroendocrine Tumors: A Systematic Review and Meta-Analysis

Stephen A. Deppen, Jeffrey Blume, Adam J. Bobbey, Chirayu Shah, Michael M. Graham, Patricia Lee, Dominique Delbeke and Ronald C. Walker
The Journal of nuclear medicine (1978), Vol.57(6), pp.872-878
06/01/2016
DOI: 10.2967/jnumed.115.165803
PMCID: PMC5362941
PMID: 26769864
url
https://doi.org/10.2967/jnumed.115.165803View
Published (Version of record) Open Access

Abstract

Neuroendocrine tumors (NETs) are uncommon tumors with increasing incidence and prevalence. Current reports suggest that Ga-68-DOTATATE PET/CT imaging improves diagnosis and staging of NETs compared with In-111-DTPA-octreotide and conventional imaging. We performed a systematic review of 68Ga-DOTATATE for safety and efficacy compared with octreotide and conventional imaging to determine whether available evidence supports U.S. Food and Drug Administration approval. Methods: Medline, EMBASE, Web of Science, and Cochrane Reviews electronic databases were searched from January 1999 to September 2015. Results were restricted to human studies comparing diagnostic accuracy of Ga-68-DOTATATE with octreotide or conventional imaging for pulmonary or gastroenteropancreatic NET and for human studies reporting safety/toxicity for Ga-68-DOTATATE with 10 subjects or more thought to have NETs. Direct communication with corresponding authors was attempted to obtain missing information. Abstracts meeting eligibility criteria were collected by a research librarian and assembled for reviewers; 2 reviewers independently determined whether or not to include each abstract. If either reviewer chose inclusion, the abstract was accepted for review. Results: Database and bibliography searches yielded 2,479 articles, of which 42 were eligible. Three studies compared the 2 radio pharmaceuticals in the same patient, finding Ga-68-DOTATATE to be more sensitive than octreotide. Nine studies compared Ga-68-DOTATATE with conventional imaging. Ga-68-DOTATATE estimated sensitivity, 90.9% (95% confidence interval, 81.4%-96.4%), and specificity, 90.6% (95% confidence interval, 77.8%-96.1%), were high. Five studies were retained for safety reporting only. Report of harm possibly related to Ga-68-DOTATATE was rare (6 of 974), and no study reported major toxicity or safety issues. Conclusion: No direct comparison of octreotide and Ga-68-DOTATATE imaging for diagnosis and staging in an unbiased population of NETs has been published. Available information in the peer-reviewed literature regarding diagnostic efficacy and safety supports the use of 68Ga-DOTATATE for imaging of NETs where it is available.
Life Sciences & Biomedicine Radiology, Nuclear Medicine & Medical Imaging Science & Technology

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