Dual Tracer 68Ga-DOTATOC and 18F-FDG PET Improve Preoperative Evaluation of Aggressiveness in Resectable Pancreatic Neuroendocrine Neoplasms
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Imaging Acquisition
2.3. PET/CT and PET/MR Image Analysis and Estimation of PET-Derived Parameters
2.4. Surgery
2.5. Pathology
2.6. Statistical Analysis
3. Results
3.1. Patients’ Population
3.2. 68Ga-DOTATOC PET-Derived Parameters as Predictors for Clinicopathological Features of Primary Tumour
3.3. 18F-FDG PET-Derived Parameters as Predictors for Clinicopathological Features of Primary Tumour
3.4. Follow-Up
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Number of Patients | 83 |
---|---|
Male, n (%) | 53 (63.9) |
Female, n (%) | 30 (36.1) |
Median age, years (IQR) | 60 (52–66.5) |
Pancreatic site, n (%) | |
Head | 31 (37.4) |
Isthmus | 4 (4.8) |
Body | 26 (31.3) |
Tail | 20 (24.1) |
Multifocal | 1 (1.2) |
Uncinate process | 1 (1.2) |
Median Lesion diameter, mm (IQR) | 28 (20–35.5) |
Median Ki-67, % (IQR) | 4 (1–8) |
WHO 2017 Classification [1], n (%) | |
G1 | 29 (35.0) |
G2 | 49 (59.0) |
G3 | 5 (6.0) |
TNM [4] | |
T (n, %) | 16 (19.3) |
T1 | 35 (42.2) |
T2 | 30 (36.1) |
T3 | 2 (2.4) |
T4 | |
N (n, %) | |
N0 | 47 (56.6) |
N1 | 31 (37.4) |
NX | 5 (6.0) |
M (n, %) | |
M0 | 69 (83.1) |
M1 | 14 (16.9) |
68Ga-DOTATOC PET parameters, median (IQR) | |
SUVvmax | 56.70 (33.04–80.66) |
SUVmean | 18.97 (12.90–35.23) |
SRD | 16.11 (6.16–43.95) |
TLSRD | 271.2 (121.0–917.0) |
18F-FDG PET parameters, median (IQR) | |
SUVmax | 5.45 (0–8.03) |
SUVmean | 3.28 (0–3.97) |
MTV | 5.65 (0–20.15) |
TLG | 19.20 (0–89.64) |
Clinicopathological Features | SUVmax | SUVmean | SRD | TLSRD | ||||
---|---|---|---|---|---|---|---|---|
AUC | p-Value | AUC | p-Value | AUC | p-Value | AUC | p-Value | |
pT3-T4 vs. pT1-T2 | 0.5260 | 1.0000 | 0.5490 | 1.0000 | 0.8177 | <0.0001 | 0.7751 | 0.0002 |
Ki-67 ≥ 3% vs. <3% | 0.5105 | 1.0000 | 0.5016 | 1.0000 | 0.6232 | 0.5278 | 0.6086 | 0.8437 |
Angioinvasion | 0.5188 | 1.0000 | 0.6253 | 0.4112 | 0.5315 | 1.0000 | 0.6036 | 0.8622 |
Distant Metastases | 0.7474 | 0.0298 | 0.6801 | 0.2789 | 0.5823 | 1.0000 | 0.5052 | 1.0000 |
Lymph nodal metastases | 0.5103 | 1.0000 | 0.6050 | 0.9556 | 0.5093 | 1.0000 | 0.5374 | 1.0000 |
Clinicopathological Features | SUVmax | SUVmean | SRD | TLSRD | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Thr | Sens | Spec | p-Value | Thr | Sens | Spec | p-Value | Thr | Sens | Spec | p-Value | Thr | Sens | Spec | p-Value | |
pT3-T4 vs. pT1-T2 | 56.65 | 56.3% | 52.9% | 1.0000 | 22.00 | 68.8% | 47.1% | 1.0000 | 18.34 | 78.1% | 72.5% | 0.0002 | 275.41 | 75.0% | 66.7% | 0.0031 |
Ki-67 ≥ 3% vs. <3% | 54.30 | 50.0% | 62.1% | 1.0000 | 16.25 | 64.8% | 55.2% | 0.6511 | 11.55 | 66.7% | 55.2% | 0.4505 | 174.69 | 75.9% | 48.3% | 0.2188 |
Angioinvasion | 61.92 | 47.5% | 59.5% | 1.0000 | 16.25 | 72.5% | 54.8% | 0.1094 | 20.40 | 50.0% | 59.5% | 1.0000 | 217.12 | 72.5% | 50.0% | 0.3123 |
Distant Metastases | 51.27 | 85.7% | 68.1% | 0.0124 | 19.03 | 71.4% | 53.6% | 0.7731 | 21.00 | 64.3% | 43.5% | 1.0000 | 287.55 | 64.3% | 50.7% | 1.0000 |
Lymph nodal metastases | 57.85 | 54.8% | 53.2% | 1.0000 | 18.05 | 71.0% | 57.4% | 0.1245 | 10.90 | 45.2% | 68.1% | 1.0000 | 266.70 | 58.1% | 51.1% | 1.0000 |
Clinicopathological Features | SUVmax | SUVmean | MTV | TLG | ||||
---|---|---|---|---|---|---|---|---|
AUC | p-Value | AUC | p-Value | AUC | p-Value | AUC | p-Value | |
pT3-T4 vs. pT1-T2 | 0.6446 | 0.3140 | 0.6278 | 0.5483 | 0.7498 | 0.0029 | 0.7392 | 0.0051 |
Ki-67 ≥ 3% vs. <3% | 0.7100 | 0.0367 | 0.7100 | 0.0367 | 0.7031 | 0.0490 | 0.7134 | 0.0317 |
Angioinvasion | 0.6809 | 0.0762 | 0.6787 | 0.0835 | 0.7656 | 0.0011 | 0.7603 | 0.0015 |
Distant Metastases | 0.6168 | 1.0000 | 0.5951 | 1.0000 | 0.6504 | 0.7101 | 0.6476 | 0.7591 |
Lymph nodal metastases | 0.5029 | 1.0000 | 0.5068 | 1.0000 | 0.5777 | 1.0000 | 0.5729 | 1.0000 |
Clinicopathological Features | SUVmax | SUVmean | MTV | TLG | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Thr | Sens | Spec | p-Value | Thr | Sens | Spec | p-Value | Thr | Sens | Spec | p-Value | Thr | Sens | Spec | p-Value | |
pT3-T4 vs. pT1-T2 | 6.20 | 55.2% | 66.7% | 0.5947 | 3.45 | 55.2% | 69.2% | 0.3654 | 17.36 | 58.6% | 94.9% | 0.0005 | 32.40 | 65.5% | 74.4% | 0.0116 |
Ki-67 ≥ 3% vs. <3% | 4.90 | 71.7% | 63.6% | 0.0545 | 2.67 | 71.7% | 63.6% | 0.0545 | 4.25 | 67.4% | 68.2% | 0.0590 | 12.95 | 71.7% | 63.6% | 0.0545 |
Angioinvasion | 6.32 | 54.5% | 73.5% | 0.1703 | 3.45 | 54.5% | 73.5% | 0.1703 | 7.98 | 69.7% | 82.4% | 0.0004 | 32.40 | 69.7% | 82.4% | 0.0004 |
Distant Metastases | 6.36 | 61.5% | 65.5% | 0.6522 | 3.45 | 61.5% | 63.6% | 0.8406 | 7.98 | 69.2% | 63.6% | 0.3099 | 59.50 | 53.8% | 76.4% | 0.3064 |
Lymph nodal metastases | 5.22 | 50.0% | 59.5% | 1.0000 | 3.16 | 53.6% | 59.5% | 1.0000 | 7.05 | 60.7% | 62.2% | 0.5608 | 32.40 | 57.1% | 64.9% | 0.6385 |
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Mapelli, P.; Partelli, S.; Salgarello, M.; Doraku, J.; Muffatti, F.; Schiavo Lena, M.; Pasetto, S.; Bezzi, C.; Bettinardi, V.; Andreasi, V.; et al. Dual Tracer 68Ga-DOTATOC and 18F-FDG PET Improve Preoperative Evaluation of Aggressiveness in Resectable Pancreatic Neuroendocrine Neoplasms. Diagnostics 2021, 11, 192. https://doi.org/10.3390/diagnostics11020192
Mapelli P, Partelli S, Salgarello M, Doraku J, Muffatti F, Schiavo Lena M, Pasetto S, Bezzi C, Bettinardi V, Andreasi V, et al. Dual Tracer 68Ga-DOTATOC and 18F-FDG PET Improve Preoperative Evaluation of Aggressiveness in Resectable Pancreatic Neuroendocrine Neoplasms. Diagnostics. 2021; 11(2):192. https://doi.org/10.3390/diagnostics11020192
Chicago/Turabian StyleMapelli, Paola, Stefano Partelli, Matteo Salgarello, Joniada Doraku, Francesca Muffatti, Marco Schiavo Lena, Stefano Pasetto, Carolina Bezzi, Valentino Bettinardi, Valentina Andreasi, and et al. 2021. "Dual Tracer 68Ga-DOTATOC and 18F-FDG PET Improve Preoperative Evaluation of Aggressiveness in Resectable Pancreatic Neuroendocrine Neoplasms" Diagnostics 11, no. 2: 192. https://doi.org/10.3390/diagnostics11020192