南方医科大学学报2025，Vol.45Issue(6)：1212-1219,8.DOI:10.12122/j.issn.1673-4254.2025.06.10
68Ga-DOTATATE、18F-FDG PET/CT双显像模式在胃肠胰神经内分泌肿瘤的分期及治疗中的价值
68 Ga-DOTATATE and 18 F-FDG PET/CT dual-modality imaging enhances precision of staging and treatment decision for gastroenteropancreatic neuroendocrine neoplasms
摘要
Abstract
Objective To evaluate the value of 68Ga-DOTATATE and 18F-FDG PET/CT imaging in staging and treatment decision for gastroenteropancreatic neuroendocrine neoplasms(GEP-NEN).Methods This retrospective analysis was conducted in 49 patients with GEP-NEN undergoing 18F-FDG and 68Ga-DOTATATE PET/CT imaging at our hospital from August,2020 to March,2023,including 34 newly diagnosed patients and 15 patients with recurrence or metastasis after treatment.GEP-NEN were classified into G1,G2,and G3 neuroendocrine tumors(NET)and neuroendocrine carcinomas(NEC)based on pathological typing.The detection efficiency were classified into 4 patterns based on the number of positive tumor lesions detected by the two tracers:68Ga-DOTATATE>18F-FDG(A);68Ga-DOTATATE=18F-FDG(B);68Ga-DOTATATE<18F-FDG(C);and complementation(D).The value of dual-modality imaging in staging and treatment decision were evaluated by visual analysis.Results In the 49 patients with GEP-NEN,68Ga-DOTATATE PET/CT was superior to 18F-FDG PET/CT for detecting systemic tumor lesions(P<0.001)and more sensitive for detecting primary/recurrent lesions,lymph node metastasis,liver metastasis,and bone metastasis(P<0.05),while 18F-FDG PET/CT had higher detection rates for lung metastasis and peritoneal metastasis(P<0.05).In terms of the detection efficiency,Pattern A was found in 46.9%(23/49)patients,Pattern B in 38.8%(19/49),Pattern C in 12.2%(6/49),and Pattern D in 2.0%(1/49).The complementary value of 18F-FDG PET/CT to 68Ga-DOTATATE PET/CT was 0%in G1 NET patients(0/13),8.3%in G2 NET patients(2/24),50%in G3 NET patients(3/6),and 33.3%in NEC patients(2/6).12.2%(6/49)of the patients had their staging confirmed or changed due to additional lesions detected by 18F-FDG PET/CT imaging,resulting subsequently in establishment or adjustment of their treatment plans.Conclusion 68Ga-DOTATATE PET/CT imaging should be the primary choice for GEP-NEN patients.Additional 18F-FDG PET/CT imaging can potentially improve precision of staging and treatment decision-making for G2,G3 and NEC patients but provides virtually no clinical benefits for G1 NET patients.关键词
神经内分泌肿瘤/生长抑素受体/奥曲肽/镓放射性同位素Ga68/氟脱氧葡萄糖F18/正电子发射断层显像术/体层摄影术/X线计算机Key words
neuroendocrine tumors/somatostatin receptor/octreotide/gallium radioisotope Ga68/fluorodeoxyglucose F18/positron emission tomography/tomography/X-ray computed引用本文复制引用
张骁翔,谭建儿,田颖,傅丽兰,张胤,董烨,谢飞,陈莉,黄衍超,吴湖炳..68Ga-DOTATATE、18F-FDG PET/CT双显像模式在胃肠胰神经内分泌肿瘤的分期及治疗中的价值[J].南方医科大学学报,2025,45(6):1212-1219,8.基金项目
国家自然科学基金(82102100,82171984) Supported by National Natural Science Foundation of China(82102100,82171984). （82102100,82171984）
