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(68)Ga-DOTATATE positron emission tomography/computed tomography scan in the detection of bone metastases in pediatric neuroendocrine tumors.

Goel R, Shukla J, Bansal D, Sodhi K, Bhattacharya A, Marwaha RK, Mittal BR - Indian J Nucl Med (2014)

Bottom Line: Contrast enhanced CT (CECT) performed at the time of PET scan acquisition was used for comparison with PET data.Imaging results were analyzed on a per-patient and on a per-lesion basis.Clinical follow-up of all patients and repeat PET/CT imaging (n = 10) was taken as the reference standard.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

ABSTRACT

Aim: The aim of this study is to evaluate the role of (68)Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) scan for the detection of bone metastases in pediatric neuroendocrine tumors (NETs) and to compare it with CT scan.

Materials and methods: A total of 30 patients (18 were males and 12 were females; age range: 1-18 years; mean age 7.6 years) with histologically confirmed NETs referred to our department were retrospectively analyzed. All patients underwent (68)Ga-DOTATATE PET/CT scan at the time of diagnosis for primary staging. Contrast enhanced CT (CECT) performed at the time of PET scan acquisition was used for comparison with PET data. Imaging results were analyzed on a per-patient and on a per-lesion basis. Clinical follow-up of all patients and repeat PET/CT imaging (n = 10) was taken as the reference standard.

Results: Out of the 30 patients, 17 had no evidence of bone metastases on any imaging modality or on clinical follow-up while the rest of 13 patients showed evidence of bone metastases (nine showing positivity both on (68)Ga-DOTATATE PET and CT scan while four showing positivity only on (68)Ga-DOTATATE PET). Compared with CT scan, (68)Ga-DOTATATE PET detected bone metastases at a significantly higher rate (P = 0.0039). On a per lesion analysis, out of a total of 225 lesions detected by (68)Ga-DOTATATE PET, only 84 lesions could be detected by CT scan.

Conclusion: (68)Ga-DOTATATE PET/CT scan is more useful than CECT scan for the early detection of bone metastases in pediatric NETs.

No MeSH data available.


Related in: MedlinePlus

A 4-year-old female child with suspected neuroblastoma showed multiple intensely 68Ga-DOTATATE avid foci in dorso-lumbar vertebrae (b) Pelvis (d) With no definite changes on computed tomography (a and c) Upstaging the disease to stage IV
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Figure 1: A 4-year-old female child with suspected neuroblastoma showed multiple intensely 68Ga-DOTATATE avid foci in dorso-lumbar vertebrae (b) Pelvis (d) With no definite changes on computed tomography (a and c) Upstaging the disease to stage IV

Mentions: In our study, the sensitivity of the conventional CT scan for the detection of bone metastases was found to be low as has also been demonstrated in a study by Putzer et al.[13] CT scan failed to pick up bone metastases in three patients of neuroblastoma and in one patient of phaeochromocytoma largely because radiographic signs of bone involvement can be very subtle and easily get missed. 68Ga-DOTATATE was useful in the characterization and upstaged the disease to stage IV, changing the management plan in a 4 year female child who was referred as a suspected case of neuroblastoma and did not show any bone involvement on the CT scan [Figure 1]. Similarly, in another patient of neuroblastoma, the presence of bone metastases upstaged the disease from stage I to stage IV [Figure 2]. 68Ga-DOTATATE PET scanning in a 16-year-old boy diagnosed with phaeochromocytoma revealed multiple sites of bone metastases which were otherwise missed by CT scan [Figure 3]. Axial skeleton is the most common site of bone metastases in phaeochromocytoma[14] similar to the findings in our study.


(68)Ga-DOTATATE positron emission tomography/computed tomography scan in the detection of bone metastases in pediatric neuroendocrine tumors.

Goel R, Shukla J, Bansal D, Sodhi K, Bhattacharya A, Marwaha RK, Mittal BR - Indian J Nucl Med (2014)

A 4-year-old female child with suspected neuroblastoma showed multiple intensely 68Ga-DOTATATE avid foci in dorso-lumbar vertebrae (b) Pelvis (d) With no definite changes on computed tomography (a and c) Upstaging the disease to stage IV
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928743&req=5

Figure 1: A 4-year-old female child with suspected neuroblastoma showed multiple intensely 68Ga-DOTATATE avid foci in dorso-lumbar vertebrae (b) Pelvis (d) With no definite changes on computed tomography (a and c) Upstaging the disease to stage IV
Mentions: In our study, the sensitivity of the conventional CT scan for the detection of bone metastases was found to be low as has also been demonstrated in a study by Putzer et al.[13] CT scan failed to pick up bone metastases in three patients of neuroblastoma and in one patient of phaeochromocytoma largely because radiographic signs of bone involvement can be very subtle and easily get missed. 68Ga-DOTATATE was useful in the characterization and upstaged the disease to stage IV, changing the management plan in a 4 year female child who was referred as a suspected case of neuroblastoma and did not show any bone involvement on the CT scan [Figure 1]. Similarly, in another patient of neuroblastoma, the presence of bone metastases upstaged the disease from stage I to stage IV [Figure 2]. 68Ga-DOTATATE PET scanning in a 16-year-old boy diagnosed with phaeochromocytoma revealed multiple sites of bone metastases which were otherwise missed by CT scan [Figure 3]. Axial skeleton is the most common site of bone metastases in phaeochromocytoma[14] similar to the findings in our study.

Bottom Line: Contrast enhanced CT (CECT) performed at the time of PET scan acquisition was used for comparison with PET data.Imaging results were analyzed on a per-patient and on a per-lesion basis.Clinical follow-up of all patients and repeat PET/CT imaging (n = 10) was taken as the reference standard.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

ABSTRACT

Aim: The aim of this study is to evaluate the role of (68)Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) scan for the detection of bone metastases in pediatric neuroendocrine tumors (NETs) and to compare it with CT scan.

Materials and methods: A total of 30 patients (18 were males and 12 were females; age range: 1-18 years; mean age 7.6 years) with histologically confirmed NETs referred to our department were retrospectively analyzed. All patients underwent (68)Ga-DOTATATE PET/CT scan at the time of diagnosis for primary staging. Contrast enhanced CT (CECT) performed at the time of PET scan acquisition was used for comparison with PET data. Imaging results were analyzed on a per-patient and on a per-lesion basis. Clinical follow-up of all patients and repeat PET/CT imaging (n = 10) was taken as the reference standard.

Results: Out of the 30 patients, 17 had no evidence of bone metastases on any imaging modality or on clinical follow-up while the rest of 13 patients showed evidence of bone metastases (nine showing positivity both on (68)Ga-DOTATATE PET and CT scan while four showing positivity only on (68)Ga-DOTATATE PET). Compared with CT scan, (68)Ga-DOTATATE PET detected bone metastases at a significantly higher rate (P = 0.0039). On a per lesion analysis, out of a total of 225 lesions detected by (68)Ga-DOTATATE PET, only 84 lesions could be detected by CT scan.

Conclusion: (68)Ga-DOTATATE PET/CT scan is more useful than CECT scan for the early detection of bone metastases in pediatric NETs.

No MeSH data available.


Related in: MedlinePlus