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Abstract：
Neuroendocrine tumors (NETs) are slow-growing tumors that express high levels of somatostatin receptors (SSTRs). Recent studies have shown the superiority of radiolabeled SSTR antagonists in theranostics compared to agonists. In this prospective study, we compared the diagnostic efficacy between [68Ga]Ga-DOTANOC and [68Ga]Ga-DATA5m-LM4 in the detection of primary and metastatic lesions in patients with well differentiated gastroenteropancreatic (GEP) NETs. Histologically proven GEP-NET patients underwent [68Ga]Ga-DOTANOC & [68Ga]Ga-DATA5m-LM4 PET/CT scans, which were analyzed. The qualitative analysis involved the visual judgment of radiotracer uptake validated by the morphological findings using CT, which was considered as the reference standard. Quantitative comparisons were presented as the standardized uptake value (SUV) corrected for lean body mass: SULpeak, SULavg, and tumor-to-background ratios (TBR). In total, 490 lesions were confirmed via diagnostic CT. The lesion-based sensitivity of [68Ga]Ga-DATA5m-LM4 PET/CT was 94.28% (462/490) and 83.46% (409/490) for [68Ga]Ga-DOTANOC PET/CT (p < 0.0001). [68Ga]Ga-DATA5m-LM4 had statistical significance over [68Ga]Ga-DOTANOC in liver metastases [100% vs. 89.4%; p < 0.0001 (292 vs. 253 {283 lesions on CT})] and bone metastases [100% vs. 82.9%; p = 0.005 (45 vs. 34 {41 lesions on CT})]. Statistical significance was also noted for the TBR SULpeak of the primary and liver lesions. [68Ga]Ga-DATA5m-LM4 showed better sensitivity and a higher target-to-background ratio than [68Ga]Ga-DOTANOC PET/CT. [68Ga]Ga-DATA5m-LM4 PET/CT can be used to quantify the extent of skeletal and liver metastases for better planning of SSTR agonist- or antagonist-based therapy.
摘要：
神经内分泌肿瘤（NETs）是生长缓慢的肿瘤，表达高水平的生长抑素受体（SSTR）。最近的研究表明，与激动剂相比，放射性标记的SSTR拮抗剂在治疗中的优越性。在这项前瞻性研究中，我们比较了[68Ga]Ga-DOTANOC和[68Ga]Ga-DATA5m-LM4在高分化胃肠胰腺(GEP)NETs患者原发灶和转移灶检测中的诊断效能.经组织学证实的GEP-NET患者接受了[68Ga]Ga-DOTANOC和[68Ga]Ga-DATA5m-LM4PET/CT扫描，进行了分析。定性分析涉及通过CT形态学发现验证的放射性示踪剂摄取的视觉判断，这被认为是参考标准。定量比较表示为针对瘦体重校正的标准化摄取值（SUV）：SULpeak，SULavg,和肿瘤背景比（TBR）。总的来说,通过诊断性CT证实了490个病灶。[68Ga]Ga-DATA5m-LM4PET/CT的病变敏感性为94.28%(462/490)和[68Ga]Ga-DOTANOCPET/CT的83.46%(409/490)(p<0.0001)。[68Ga]Ga-DATA5m-LM4在肝转移中与[68Ga]Ga-DOTANOC相比具有统计学意义[100％vs.89.4%；p<0.0001（292对253{283个病灶在CT上})]和骨转移[100%vs.82.9%；p=0.005（45vs.34{CT上41个病灶})]。还注意到原发性和肝脏病变的TBRSULpeak的统计显著性。[68Ga]Ga-DATA5m-LM4显示出比[68Ga]Ga-DOTANOCPET/CT更好的灵敏度和更高的目标背景比。[68Ga]Ga-DATA5m-LM4PET/CT可用于量化骨骼和肝脏转移的程度，以更好地规划基于SSTR激动剂或拮抗剂的治疗。
