PDF(Pubmed)
Abstract：
Purpose: Somatostatin receptor imaging with 18F-AlF-NOTA-octreotide (18F-AlF-OC) has shown promising performance in neuroendocrine neoplasms (NENs). In this study, we aim to investigate the diagnostic performance and clinical impact of 18F-AlF-OC in a large prospective cohort of patients with NEN. Methods: Between January 2023 and November 2023, a total of 219 patients with confirmed or suspected NEN were enrolled prospectively and underwent 18F-AlF-OC PET/CT at 2 h post-injection. The primary endpoint was the diagnostic performance, including sensitivity, specificity, and accuracy. An additional primary endpoint was the impact of 18F-AlF-OC on clinical management. The reference standard was based on the results of histopathology or radiological follow-up. Results: 205 patients were included in the final analysis. The patient-level sensitivity, specificity, and accuracy of 18F-AlF-OC PET/CT compared with contrast-enhanced CT/MRI were 90.5% vs. 81.8%, 93.1% vs. 71.1%, and 91.2% vs. 79.4%, respectively. 26 patients had tiny gastrointestinal NENs (smaller than 1 cm in diameter). The patient-based sensitivity of 18F-AlF-OC PET/CT and contrast-enhanced CT/MRI were 61.5% (16/26) and 37.5% (9/24), respectively. The smallest diameter of gastrointestinal NEN detected by 18F-AlF-OC PET/CT was 0.6 cm in the rectum, 0.3 cm in the stomach, and 0.5 cm in the duodenum. 18F-AlF-OC PET/CT results led to changes in clinical management in 19.5% of patients (40/205), owing mainly to new or unexpected findings compared to contrast-enhanced CT/MRI. Conclusion: 18F-AlF-OC PET/CT demonstrated great diagnostic performance in patients with NEN, particularly for detecting tiny gastrointestinal NEN. Furthermore, 18F-AlF-OC PET/CT impacted the therapeutic management in 19.5% of patients. Our results further validate the role of 18F-AlF-OC as a somatostatin receptor imaging tracer in clinical practice.
摘要：
目的：18F-AlF-NOTA-奥曲肽（18F-AlF-OC）的生长抑素受体显像在神经内分泌肿瘤（NENs）中显示出有希望的表现。在这项研究中,我们旨在研究18F-AlF-OC在NEN患者的大型前瞻性队列中的诊断表现和临床影响.方法：在2023年1月至2023年11月之间，前瞻性纳入了219例确诊或疑似NEN的患者，并在注射后2h接受了18F-AlF-OCPET/CT检查。主要终点是诊断性能，包括灵敏度,特异性，和准确性。另一个主要终点是18F-AlF-OC对临床管理的影响。参考标准基于组织病理学或放射学随访的结果。结果：205例患者纳入最终分析。患者层面的敏感度，特异性，18F-AlF-OCPET/CT与对比增强CT/MRI的准确率分别为90.5%和81.8%,93.1%vs.71.1%,和91.2%vs.79.4%,分别。26例患者有微小的胃肠道NENs（直径小于1厘米）。18F-AlF-OCPET/CT和对比增强CT/MRI的患者敏感度分别为61.5%(16/26)和37.5%(9/24),分别。18F-AlF-OCPET/CT检出直肠内最小直径为0.6cm,胃中0.3厘米，和0.5厘米的十二指肠。18F-AlF-OCPET/CT结果导致19.5％的患者（40/205）的临床管理发生变化，与对比增强CT/MRI相比，主要是由于新的或意外的发现。结论:18F-AlF-OCPET/CT对NEN有较好的诊断价值,特别是用于检测微小的胃肠NEN。此外，18F-AlF-OCPET/CT影响了19.5%的患者的治疗管理。我们的结果进一步验证了18F-AlF-OC作为生长抑素受体成像示踪剂在临床实践中的作用。
