SNMMI: PET/CT biomarker impacts management of neuroendocrine tumors

MIAMI—Ga-68 DOTATATE PET/CT imaging was highly sensitive and specific for assessing neuroendocrine tumors and changed the course of treatment for more than one-third of patients, according to results of a study presented June 11 at the annual meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI).

Neuroendocrine tumors have different behaviors in prognosis and therapy according to their origin, and staging, grading and clinical decision making can be challenging, the study's lead investigator Niklaus G. Schaefer, MD, medical oncologist at the University Hospital of Zurich in Switzerland, said in a statement.

Schaefer and colleagues designed a prospective trial to investigate the Ga-68 DOTATATE biomarker in 61 patients with low-to-intermediate grade neuroendocrine tumors and compare pre- and post-imaging clinical management strategies.

Prior to imaging, more than half of the patients were considered eligible for surgery to remove their cancer. The remaining 29 were determined to be inoperable.

Images were evaluated in consensus by a medical oncologist, surgeon trained in neuroendocrine tumors, radiologist and nuclear medicine physician. After the molecular imaging studies, 36 percent of patients had a change in management. Of those who were originally classified as operable, 14 were subsequently considered ineligible for surgery. For patients who were at first considered inoperable, eight patients were classified as potentially resectable and were referred for surgical resection of their tumors.

“The study shows that this particular molecular imaging technique does significantly change patient management, identifying operable and curable symptomatic patients or sparing patients from futile surgery,” said Schaefer. “The positive impact on our patients is also significant. This serves as a model for further use of molecular imaging to assess neuroendocrine tumors.”