NEUROENDOCRINE TUMOR IMAGING

68Ga-DOTATATE Compared With 111In-DTPA-Octroeotide and Conventional Imaging for Pulmonary and Gastroenteropancreatic Neuroendocrine Tumors: A Systematic Review and Meta-analysis

Deppen SA, Blume J, Bobbey AJ, et al
J Nucl Med. 2016;57:872-878

Summary

This systematic review and meta-analysis compared 68Ga-DOTATATE positron emission tomography (PET) with 111In-DTPA-pentetreotide (octreotide) scintigraphy in patients with pulmonary and gastroenteropancreatic neuroendocrine tumors.

A comprehensive search of data published between January 1999 and September 2015 yielded 42 eligible articles. 68Ga-DOTATATE was more sensitive than 111In-DTPA-octreotide and conventional imaging. The estimated sensitivity for 68Ga-DOTATATE was 90.9% (95% confidence interval, 81.4%-96.4%) and the specificity was 90.6% (95% confidence interval, 77.8%-96.1%). No major toxicity was reported; there were only rare minor adverse events.

The authors concluded that—given its superior image quality, lower radiation dosimetry, and more streamlined imaging acquisition and improved patient convenience (imaging 2 hours after 68Ga-DOTATATE injection compared with 2 or 3 days after 111In-DTPA-octreotide injection)—68Ga-DOTATATE should be used in preference over 111In-DTPA-octreotide where available.

Viewpoint

Systematic reviews and meta-analysis make important contributions to the relevant literature,^[1] and this timely investigation mined literature to compare 68Ga-DOTATATE PET (and PET/CT) versus 111In-DTPA-octreotide scintigraphy in patients with neuroendocrine tumors.

68Ga-DOTATATE PET was approved by the US Food and Drug Administration recently.^[2] Although other reviews have been published on this imaging agent, the new study put 68Ga-DOTATATE head to head with the "historic" standard of reference, 111In-DTPA-scintigraphy.^[3,4] In summary, it is quite evident that the time has come to replace "historic" with the "modern" standard of reference in this clinical setting.