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John Ramage, Boris G Naraev, Thorvardur R Halfdanarson
177 Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) is now approved for patients with advanced gastroenteropancreatic neuroendocrine tumors (NET), and it is therefore important to understand the efficacy and safety of PRRT in this patient population. PRRT efficacy and safety outcomes have frequently been summarized for patient populations with gastroenteropancreatic NET, but not specifically in patients with pancreatic NET (panNET). The pivotal phase 3 trial of 177 Lu-DOTATATE PRRT in NET was restricted to patients with a midgut primary site...
August 2018: Seminars in Oncology
Gwennaëlle Marin, Bruno Vanderlinden, Ioannis Karfis, Thomas Guiot, Zena Wimana, Nick Reynaert, Stefaan Vandenberghe, Patrick Flamen
PURPOSE: Peptide receptor radionuclide therapy with 177 Lu-DOTATATE has become a standard treatment modality in neuroendocrine tumours (NETs). No consensus has yet been reached however regarding the absorbed dose threshold for lesion response, the absorbed dose limit to organs-at-risk, and the optimal fractionation and activity to be administered. This is partly due to a lack of uniform and comparable dosimetry protocols. The present article details the development of an organ-at-risk dosimetry procedure, which could be implemented and used routinely in a clinical context...
December 2018: Physica Medica: PM
Satya Das, Gino Pineda, Laura Goff, Rachel Sobel, Jordan Berlin, George Fisher
BACKGROUND: Metastases to the orbit occur rarely in midgut neuroendocrine tumor (NET) patients with only 20 cases reported to date. Patients typically present with bilateral involvement of the recti muscles and experience symptoms such as diplopia, proptosis, and decreased vision. Although orbital MRI remains the gold standard for imaging orbital disease, many orbital lesions are now detected on somatostatin-receptor (SSTR) based imaging such as 68Ga-DOTATATE PET-CT. CASE PRESENTATIONS: Patient 1 is a 72 year-old female with a well-differentiated G3 ileal NET who was incidentally diagnosed with orbital metastases during a hospitalization for pre-septal cellulitis in 2018...
December 6, 2018: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
Elin Pauwels, Frederik Cleeren, Guy Bormans, Christophe M Deroose
Somatostatin receptors (SSTRs) are variably expressed by a variety of malignancies. Using radiolabeled somatostatin analogs (SSAs), the presence of SSTRs on tumor cells may be exploited for molecular imaging and for peptide receptor radionuclide therapy. 111 In-DTPA-octreotide has long been the standard in SSTR scintigraphy. A major leap forward was the introduction of gallium-68 labeled SSAs for positron emission tomography (PET) offering improved sensitivity. Tracers currently in clinical use are 68 Ga-DOTA-Tyr3 -octreotide (68 Ga-DOTATOC), 68 Ga-DOTA-Tyr3 -octreotate (68 Ga-DOTATATE) and 68 Ga-DOTA-1-NaI3 -octreotide (68 Ga-DOTANOC), collectively referred to as 68 Ga-DOTA-peptides...
2018: American Journal of Nuclear Medicine and Molecular Imaging
Lore Santoro, Erick Mora-Ramirez, Dorian Trauchessec, Soufiane Chouaf, Pierre Eustache, Jean-Pierre Pouget, Pierre-Olivier Kotzki, Manuel Bardiès, Emmanuel Deshayes
BACKGROUND: This study's aim was to develop our dosimetric methodology using a commercial workstation for the routine evaluation of the organs at risk during peptide receptor radionuclide therapy (PRRT) with 177 Lu. METHODS: First, planar and SPECT sensitivity factors were determined on phantoms. The reconstruction parameters were optimized by SPECT/CT image acquisition using a NEMA IEC phantom containing a 500 ml bottle of 177 Lu, to simulate a kidney. The recovery coefficients were determined on various phantoms...
November 29, 2018: EJNMMI Research
Kai Huang, Winfried Brenner, Vikas Prasad
Radioligand therapy (RLT) is considered a safe treatment for patients with metastasized neuroendocrine tumors (NET) and prostate cancer (PC), and the occurrence of tumor lysis syndrome (TLS) with 177 Lutetium (177 Lu)-labeled peptides has not been reported so far. We retrospectively screened our patients' database for TLS after RLT in NET and PC. Methods: The database was searched for patients receiving RLT with 177 Lu-DOTATATE, -DOTATOC or -PSMA and showing laboratory or clinical abnormalities typical for TLS within 7 days after start of treatment...
November 21, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
G Dos Santos, M García Fontes, H Engler, O Alonso
BACKGROUND AND OBJECTIVES: To prospectively compare the detection rate of 68 Ga-DOTATATE versus 11 C-choline PET/CT in patients with prostate cancer in biochemical relapse, and to evaluate somatostatin receptor expression in vivo to plan targeted therapies (177 Lu-DOTATATE). MATERIAL AND METHODS: We prospectively analysed 64 patients with biochemical relapse (median PSA: 4.25 ng/mL). A PET/CT was performed with 11 C-choline, and another with 68 Ga-DOTATATE. The SUVmax was measured in all lesions...
November 12, 2018: Revista Española de Medicina Nuclear e Imagen Molecular
Nir Hod, Daniel Levin, Reut Anconina, Elya Benkovich, Dina Ezroh Kazap, Sophie Lantsberg
Schmorl's node (SN) arises from the herniation of the nucleus pulposus of the disc through the cartilaginous endplate into the body of the vertebra. Our report describes a patient with carcinoid tumor who underwent a series of Ga-DOTATATE PET/CT scans for follow-up, demonstrating gradually increasing focal vertebral uptake in absence of CT abnormality, suspicious for a metastasis. Both CT and MRI eventually revealed classical findings of a SN. Also observed in the same vertebra is a degenerative osteophyte showing intense Ga-DOTATATE uptake...
November 10, 2018: Clinical Nuclear Medicine
John F Tierney, Cory Kosche, Erik Schadde, Amjad Ali, Sumeet Virmani, Sam G Pappas, Jennifer Poirier, Xavier M Keutgen
BACKGROUND: 68 Gallium-DOTATATE positron emission tomography-computed tomography (PET CT) has shown superior accuracy in detecting grade 1 and 2 neuroendocrine tumors over previous imaging modalities and was recently included in National Comprehensive Cancer Network guidelines. It remains unclear which patients benefit most from this imaging modality. We therefore reviewed our initial experience with 68 Gallium-DOTATATE PET CT to evaluate its usefulness in diagnosing, staging, and surveilling neuroendocrine tumors...
November 8, 2018: Surgery
Rudolf A Werner, Heribert Hänscheid, Jeffrey P Leal, Mehrbod S Javadi, Takahiro Higuchi, Martin A Lodge, Andreas K Buck, Martin G Pomper, Constantin Lapa, Steven P Rowe
PURPOSE: As has been previously reported, the somatostatin receptor (SSTR) imaging agent [68 Ga]-labeled 1,4,7,10-tetraazacyclododecane-N,N',N″,N‴-tetraacetic acid-d-Phe(1)-Tyr(3)-octreotate ([68 Ga]DOTATATE) demonstrates lower uptake in normal organs in patients with a high neuroendocrine tumor (NET) burden. Given the higher SSTR affinity of [68 Ga] DOTATATE, we aimed to quantitatively investigate the biodistribution of [68 Ga]-labeled 1,4,7,10-tetraazacyclododecane-N,N',N″,N‴-tetraacetic acid-d-Phe(1)-Tyr(3)-octreotide ([68 Ga]DOTATOC) to determine a potential correlation between uptake in normal organs and NET burden...
November 7, 2018: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
Alberto Puccini, Francesca Battaglin, Heinz-Josef Lenz
Small bower cancer is a rare disease, despite its incidence is increasing in the last decade. Both benign and malignant tumors can arise from the small intestine. The main histological cancer types are adenocarcinomas, neuroendocrine tumors, sarcomas, gastrointestinal stromal tumors (GISTs), and lymphomas. Due to the rarity of these malignances, all the currently available data are based on small studies or retrospective series, although recent breakthroughs are redirecting our approach to these patients. Immunotherapy for small bowel adenocarcinomas, several multikinase inhibitors in resistant GIST patients, as well as everolimus and 177 Lu-DOTATATE in neuroendocrine tumors are only few of the novel therapeutic options that have changed, or may change in the future, the therapeutic landscape of these rare cancers...
November 5, 2018: Current Treatment Options in Oncology
Karine A Al Feghali, Debra N Yeboa, Beth Chasen, Maria K Gule, Jason M Johnson, Caroline Chung
We hereby report the case of a patient with optic nerve sheath meningioma (ONSM), whose diagnosis and multidisciplinary management was guided by the use of Gallium-68 (68 Ga)-labeled dodecanetetraacetic acid-tyrosine-3-octreotate (DOTATATE) positron emission tomography (PET)/computed tomography (CT) scan. We briefly review the diagnosis and management of ONSM, and review the literature on the role and current status of nuclear imaging with somatostatin receptor ligands in the non-invasive diagnosis and management of meningiomas...
2018: Frontiers in Oncology
(no author information available yet)
No abstract text is available yet for this article.
September 10, 2018: Medical Letter on Drugs and Therapeutics
Simone Krebs, Neeta Pandit-Taskar, Diane Reidy, Bradley J Beattie, Serge K Lyashchenko, Jason S Lewis, Lisa Bodei, Wolfgang A Weber, Joseph A O'Donoghue
PURPOSE: Somatostatin receptor antagonists have shown promise for imaging neuroendocrine tumors (NETs) in preclinical studies, but clinical data is still very limited. In this study, we assess the feasibility of using the novel somatostatin antagonist 68 Ga-DOTA-JR11 for PET imaging of NETs. METHODS: Twenty patients with advanced NETs underwent whole-body PET/CT imaging 60 min after injection of 169 MBq (median) 68 Ga-DOTA-JR11 as part of a prospective study. Volumes of interest were drawn around up to four 68 Ga-DOTA-JR11-avid lesions per patient (with uptake greater than liver) and standardized uptake values were estimated...
October 29, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Andrew John Bosserman, Dong Dai, Yang Lu
A 71-year-old man with history of prostate cancer is evaluated for rising prostate-specific antigen. The patient also has a history of rectal well-differentiated neuroendocrine tumor. On F-fluciclovine PET/CT, 2 retroperitoneal lymph nodes exhibited intense fluciclovine avidity, whereas one enlarged perirectal lymph node only showed background uptake. On further Ga-DOTATATE PET/CT, the perirectal lymph node revealed intense DOTATATE avidity, whereas the 2 retroperitoneal lymph nodes only with similar to background DOTATATE avidity...
October 27, 2018: Clinical Nuclear Medicine
Sebastian Hoberück, Enrico Michler, Klaus Zöphel, Ivan Platzek, Jörg Kotzerke, Claudia Brogsitter
A 65-year-old woman with a long history of metastasized, highly differentiated (G1) neuroendocrine tumor of pancreatic origin presented for follow-up Ga-DOTATATE PET/CT after 7 peptide receptor radiotherapies. In the previous scan, she already had discrete intracranial tracer accumulations, which were massively progressive in the recent Ga-DOTATATE PET/CT 8 months later. This case illustrates that cerebral metastases in neuroendocrine tumors may occur many years after initial diagnosis, and their somatostatin receptor expression may rise within a few months to a level that reasonably justifies further peptide receptor radiotherapy...
October 27, 2018: Clinical Nuclear Medicine
Michael S Dressen, Ashok Muthukrishnan, Tyson R Tragon, Frank S Lieberman, James M Mountz
Ga-DOTATATE imaging for meningiomas is gaining clinical use for selecting patients that may benefit from targeted therapy (eg, Lu-DOTATATE). We present an image of a 67-year-old man with an intracranial WHO grade III anaplastic meningioma. He underwent tumor resection followed by intensity-modulated radiation therapy but experienced a recurrence 25 months later. He received an F-(FDG) and Ga-DOTATATE PET/MR to evaluate for the presence of somatostatin receptor expression and guide subsequent treatment. The scans showed both concordant and discordant regions of uptake, indicating that high somatostatin receptor (SSTR2) expression may not coincide with areas of increased metabolic rate...
October 27, 2018: Clinical Nuclear Medicine
Emine Acar, Gamze Çapa Kaya
Prostate large cell neuroendocrine tumor is a rare disease. In this case, metastatic areas showing FDG uptake, somatostatin receptor positivity, and PSMA expression are shown in F-FDG PET/CT, Ga-DOTATATE PET/CT, and Ga-PSMA PET/CT in a 70-year-old man with the diagnosis of prostate large cell neuroendocrine carcinoma.
October 15, 2018: Clinical Nuclear Medicine
Ashwini Kalshetty, Anant Ramaswamy, Vikas Ostwal, Sandip Basu
BACKGROUND AND AIMS: Functioning and symptomatic disease resistant to conventional therapies constitutes a subset amongst neuroendocrine tumors (NETs) that are commonly considered for peptide receptor radionuclide therapy (PRRT). The aim of this study was to evaluate the efficacy of Lu-DOTATATE PRRT in this group with objective assessment criteria. MATERIALS AND METHODS: A total of 46 patients with refractory or progressive symptomatic GEP-NETs (previously treated at various stages with long-acting octreotide, chemotherapy, multikinase inhibitors, etc...
December 2018: Nuclear Medicine Communications
Mauro Cives, Jonathan R Strosberg
Neuroendocrine tumors (NETs) are heterogeneous malignancies arising from the diffuse neuroendocrine system. They frequently originate in the gastroenteropancreatic (GEP) tract and the bronchopulmonary tree, and their incidence has steadily increased in the last 3 decades. Fundamental biologic and genomic differences underlie the clinical heterogeneity of NETs, and distinct molecular features characterize NETs of different grades and different primary sites. Although surgery remains the cornerstone of treatment for localized tumors, systemic treatment options for patients with metastatic NETs have expanded considerably...
October 8, 2018: CA: a Cancer Journal for Clinicians
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