68Gallium DOTANOC-PET imaging in Lung Carcinoids: impact on patients’ management

Research output: Contribution to journalArticlepeer-review

  • External authors:
  • Angela Lamarca
  • D Mark Pritchard
  • Thomas Westwood
  • Georgios Papaxoinis
  • Daisuke Nonaka
  • Sobhan Vinjamuri
  • Prakash Manoharan
  • Wasat Mansoor

Abstract

Background
68Gallium DOTA-PET imaging is preferable to standard somatostatin receptor scintigraphy where available; however, its role in the management of Lung Carcinoid tumours (LC) remains unclear.
Methods
All consecutive patients with histologically-confirmed LC from two ENETS Centres of Excellence were identified retrospectively. The primary objective was to assess the impact of 68Ga-DOTANOC-PET on clinical management in patients with LC.
Results
Of 166 patients screened, 46 were eligible: 52% female, median age 57 years (range 21-86); type of LC: DIPNECH (4%), typical (44%), atypical (35%), not reported (17%); stage: localised (63%), locally advanced (13%) and metastatic (17%) (7% unknown). A total of 47 68Ga-DOTANOCs were performed with the following rationale: LC diagnosis confirmation (4; 9%), primary tumour identification (2; 4%), post-surgical assessment (19; 40%), staging (patients with known LC present at time of 68Ga-DOTANOC) (19; 40%) and consideration of Peptide Receptor Radionuclide Therapy (PRRT) (3; 7%). Twenty-seven (57%) scans showed evidence of non-physiological uptake: median SUVmax 7.2 (range 1.42-53). 68Ga-DOTANOC provided additional information in 37% (95%CI 22-51) of patients and impacted on management in 26% (95%-CI 12-41); 9 patients (21%) were identified to have occult sites of metastases. Out of the 19 patients with post-surgical 68Ga-DOTANOC, 3 (16%) were identified to have distant metastases. There were no differences in the rate of practice changing 68Ga-DOTANOC results by type of LC (p-value 0.5).
Conclusions
Our results support the role of 68Ga-DOTANOC for optimizing the management of patients with LC, including post-surgical re-staging due to potential for identifying occult metastases.

Bibliographical metadata

Original languageEnglish
JournalNeuroendocrinology
Early online date12 Apr 2017
DOIs
Publication statusPublished - 2017

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