Clinical impact of using [<scp><sup>18</sup>F</scp>]<scp>AlF</scp>‐<scp>NOTA</scp>‐octreotide <scp>PET</scp>/<scp>CT</scp> instead of [<scp><sup>68</sup>Ga</scp>]Ga‐<scp>DOTA</scp>‐<scp>SSA PET</scp>/<scp>CT</scp>: Secondary endpoint analysis of a multicenter, prospective trial-Reference-Cited by-同舟云学术

Clinical impact of using [¹⁸F]AlF‐NOTA‐octreotide PET/CT instead of [⁶⁸Ga]Ga‐DOTA‐SSA PET/CT: Secondary endpoint analysis of a multicenter, prospective trial

Published:2024-06-04 Issue:8 Volume:36 Page:
ISSN:0953-8194
Container-title:Journal of Neuroendocrinology
language:en
Short-container-title:J Neuroendocrinology

Author:

Leupe Hannes¹^ORCID,Pauwels Elin¹,Vandamme Timon²³,Van den Broeck Bliede⁴,Lybaert Willem³,Dekervel Jeroen⁵,Van Herpe Filip⁵,Jaekers Joris⁶,Cleeren Frederik⁷,Hofland Johannes⁸^ORCID,Brouwers Adrienne⁹,Koole Michel¹,Bormans Guy⁷,Van Cutsem Eric⁵,Geboes Karen¹⁰,Laenen Annouschka¹¹,Verslype Chris⁵,Stroobants Sigrid¹²,Deroose Christophe M.¹^ORCID

Affiliation:

1. Department of Imaging and Pathology Nuclear Medicine, University Hospitals Leuven & Nuclear Medicine and Molecular Imaging, KU Leuven Leuven Belgium

2. Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON) University of Antwerp Antwerp Belgium

3. Department of Oncology Antwerp University Hospital & NETwerk Antwerpen‐Waasland CoE Edegem Belgium

4. Nuclear Medicine Ghent University Hospital Ghent Belgium

5. Digestive Oncology University Hospitals Leuven Leuven Belgium

6. Department of Visceral Surgery University Hospitals Leuven Leuven Belgium

7. Radiopharmaceutical Research, Department of Pharmacy and Pharmacology KU Leuven Leuven Belgium

8. Department of Internal Medicine, Section of Endocrinology ENETS Centre of Excellence Rotterdam, Erasmus MC Cancer Institute Rotterdam The Netherlands

9. Department of Nuclear Medicine and Molecular Imaging University of Groningen, University Medical Center Groningen Groningen The Netherlands

10. Digestive Oncology, Department of Gastroenterology Ghent University Hospital Ghent Belgium

11. Leuven Biostatistics and Statistical Bioinformatics Center KU Leuven Leuven Belgium

12. Nuclear Medicine, Antwerp University Hospital & Molecular Imaging and radiology, Faculty of Medicine and Health Sciences University of Antwerp Wilrijk Belgium

Abstract

Abstract[18F]AlF‐NOTA‐octreotide ([18F]AlF‐OC) is a promising alternative for [68Ga]Ga‐DOTA‐somatostatin analogs (SSAs) in positron emission tomography (PET) imaging of the somatostatin receptor (SSTR). Our aim is to assess changes in TNM staging and differences in patient management between [18F]AlF‐OC PET/CT and [68Ga]Ga‐DOTA‐SSA PET/CT in the work‐up of neuroendocrine tumor (NET) patients. Patients who underwent both [18F]AlF‐OC and [68Ga]Ga‐DOTA‐TATE or [68Ga]Ga‐DOTA‐NOC PET/CT in our multicenter study (Pauwels et al., J Nucl Med.2023;63:632–638) with a NET were included for analysis. TNM staging was determined and compared for both tracers. For each patient, the blinded [68Ga]Ga‐DOTA‐SSA or [18F]AlF‐OC PET/CT images were presented in random order at a multidisciplinary team board. The images were presented together with clinical information and compared with previous SSTR and [18F]FDG PET/CT imaging. After a consensus decision for patient management was recorded, the board was presented with the PET/CT images from the other SSTR tracer and a decision was made for the second tracer. Differences in management were classified as major if it entailed an intermodality change and minor if it led to an intramodality change. Compared with [68Ga]Ga‐DOTA‐SSA, the use of [18F]AlF‐OC led to a change in 16/75 patients: TNM staging changes in 10/75 patients (13.3%; downstaging in 3/10, upstaging in 7/10) and differences in clinical management were seen in 10/75 patients (13.3%), leading to a major difference in 7/10 cases and a minor change in 3/10 cases. All 10 cases with a difference in patient management between both PET tracers were caused by additional lesion detection by [18F]AlF‐OC. The use of [18F]AlF‐OC did not impact TNM staging or clinical management in the large majority of the patients (86.7%), further validating the potential for routine clinical use of [18F]AlF‐OC PET/CT as an alternative for [68Ga]Ga‐DOTA‐SSA PET/CT. The trial is registered under ClinicalTrials.gov identifier NCT04552847 and EudraCT 2020–000549‐15.

Publisher

Wiley

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jne.13420

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