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68Ga-DOTATATE PET/CT imaging of indeterminate pulmonary nodules and lung cancer.

Publication ,  Journal Article
Walker, R; Deppen, S; Smith, G; Shi, C; Lehman, J; Clanton, J; Moore, B; Burns, R; Grogan, EL; Massion, PP
Published in: PLoS One
2017

PURPOSE: 18F-FDG PET/CT is widely used to evaluate indeterminate pulmonary nodules (IPNs). False positive results occur, especially from active granulomatous nodules. A PET-based imaging agent with superior specificity to 18F-FDG for IPNs, is badly needed, especially in areas of endemic granulomatous nodules. Somatostatin receptors (SSTR) are expressed in many malignant cells including small cell and non-small cell lung cancers (NSCLCs). 68Ga-DOTATATE, a positron emitter labeled somatostatin analog, combined with PET/CT imaging, may improve the diagnosis of IPNs over 18F-FDG by reducing false positives. Our study purpose was to test this hypothesis in our region with high endemic granulomatous IPNs. METHODS: We prospectively performed 68Ga-DOTATATE PET/CT and 18F-FDG PET/CT scans in the same 30 patients with newly diagnosed, treatment-naïve lung cancer (N = 14) or IPNs (N = 15) and one metastatic nodule. 68Ga-DOTATATE SUVmax levels at or above 1.5 were considered likely malignant. We analyzed the scan results, correlating with ultimate diagnosis via biopsy or 2-year chest CT follow-up. We also correlated 68Ga-DOTATATE uptake with immunohistochemical (IHC) staining for SSTR subtype 2A (SSTR2A) in pathological specimens. RESULTS: We analyzed 31 lesions in 30 individuals, with 14 (45%) being non-neuroendocrine lung cancers and 1 (3%) being metastatic disease. McNemar's result comparing the two radiopharmaceuticals (p = 0.65) indicates that their accuracy of diagnosis in this indication are equivalent. 68Ga-DOTATATE was more specific (94% compared to 81%) and less sensitive 73% compared to 93%) than 18F-FDG. 68Ga-DOTATATE uptake correlated with SSTR2A expression in tumor stroma determined by immunohistochemical (IHC) staining in 5 of 9 (55%) NSCLCs. CONCLUSION: 68Ga-DOTATATE and 18F-FDG PET/CT had equivalent accuracy in the diagnosis of non-neuroendocrine lung cancer and 68Ga-DOTATATE was more specific than 18F-FDG for the diagnosis of IPNs. IHC staining for SSTR2A receptor expression correlated with tumor stroma but not tumor cells.

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Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2017

Volume

12

Issue

2

Start / End Page

e0171301

Location

United States

Related Subject Headings

  • Positron Emission Tomography Computed Tomography
  • Organometallic Compounds
  • Neoplasm Metastasis
  • Multiple Pulmonary Nodules
  • Multimodal Imaging
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • General Science & Technology
 

Citation

APA
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Walker, R., Deppen, S., Smith, G., Shi, C., Lehman, J., Clanton, J., … Massion, P. P. (2017). 68Ga-DOTATATE PET/CT imaging of indeterminate pulmonary nodules and lung cancer. PLoS One, 12(2), e0171301. https://doi.org/10.1371/journal.pone.0171301
Walker, Ronald, Stephen Deppen, Gary Smith, Chanjuan Shi, Jonathan Lehman, Jeff Clanton, Brandon Moore, Rena Burns, Eric L. Grogan, and Pierre P. Massion. “68Ga-DOTATATE PET/CT imaging of indeterminate pulmonary nodules and lung cancer.PLoS One 12, no. 2 (2017): e0171301. https://doi.org/10.1371/journal.pone.0171301.
Walker R, Deppen S, Smith G, Shi C, Lehman J, Clanton J, et al. 68Ga-DOTATATE PET/CT imaging of indeterminate pulmonary nodules and lung cancer. PLoS One. 2017;12(2):e0171301.
Walker, Ronald, et al. “68Ga-DOTATATE PET/CT imaging of indeterminate pulmonary nodules and lung cancer.PLoS One, vol. 12, no. 2, 2017, p. e0171301. Pubmed, doi:10.1371/journal.pone.0171301.
Walker R, Deppen S, Smith G, Shi C, Lehman J, Clanton J, Moore B, Burns R, Grogan EL, Massion PP. 68Ga-DOTATATE PET/CT imaging of indeterminate pulmonary nodules and lung cancer. PLoS One. 2017;12(2):e0171301.

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2017

Volume

12

Issue

2

Start / End Page

e0171301

Location

United States

Related Subject Headings

  • Positron Emission Tomography Computed Tomography
  • Organometallic Compounds
  • Neoplasm Metastasis
  • Multiple Pulmonary Nodules
  • Multimodal Imaging
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • General Science & Technology