Oncotarget

Research Papers:

Prognostic value of a three-scale grading system based on combining molecular imaging with 68Ga-DOTATATE and 18F-FDG PET/CT in patients with metastatic gastroenteropancreatic neuroendocrine neoplasias

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Oncotarget. 2020; 11:589-599. https://doi.org/10.18632/oncotarget.27460

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Ioannis Karfis _, Gwennaëlle Marin, Hugo Levillain, Stylianos Drisis, Raoul Muteganya, Gabriela Critchi, Loubna Taraji-Schiltz, Carlos Artigas Guix, Leila Shaza, Meriem Elbachiri, Laura Mans, Godelieve Machiels, Alain Hendlisz and Patrick Flamen

Abstract

Ioannis Karfis1, Gwennaëlle Marin1, Hugo Levillain1, Stylianos Drisis2, Raoul Muteganya1, Gabriela Critchi1, Loubna Taraji-Schiltz1, Carlos Artigas Guix1, Leila Shaza3, Meriem Elbachiri3, Laura Mans3, Godelieve Machiels3, Alain Hendlisz3 and Patrick Flamen1

1 Nuclear Medicine Department, Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium

2 Radiology/Medical Imaging Department, Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium

3 Digestive Oncology Department, Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium

Correspondence to:

Ioannis Karfis,email: ioannis.karfis@bordet.be

Keywords: gastroenteropancreatic neuroendocrine neoplasias; molecular imaging; prognostic biomarkers; 68Ga-DOTATATE PET/CT; 18F-FDG PET/CT

Received: October 02, 2019     Accepted: January 13, 2020     Published: February 11, 2020

ABSTRACT

We investigated on the added prognostic value of a three-scale combined molecular imaging with 68Ga-DOTATATE and 18F-FDG PET/CT, (compared to Ki-67 based histological grading), in gastroenteropancreatic neuroendocrine neoplasia patients. 85 patients with histologically proven metastatic gastroenteropancreatic neuroendocrine neoplasias, who underwent combined PET/CT imaging were retrospectively evaluated. Highest Ki-67 value available at time of 18F-FDG PET/CT was recorded. Patients were classified according to World Health Organization/European Neuroendocrine Tumor Society histological grades (G1, G2, G3) and into three distinct imaging categories (C1: all lesions are 18F-FDG negative/68Ga-DOTATATE positive, C2: patients with one or more 18F-FDG positive lesions, all of them 68Ga-DOTATATE positive, C3: patients with one or more 18F-FDG positive lesions, at least one of them 68Ga-DOTATATE negative). The primary endpoint of the study was Progression-Free Survival, assessed from the date of 18F-FDG PET/CT to the date of radiological progression according to Response Evaluation Criteria In Solid Tumors version 1.1. Classification according to histological grade did not show significant statistical difference in median Progression-Free Survival between G1 and G2 but was significant between G2 and G3 patients. In contrast, median Progression-Free Survival was significantly higher in C1 compared to C2 and in C2 compared to C3 patients, revealing three distinctive imaging categories, each with highly distinctive prognosis. Our three-scale combined 68Ga-DOTATATE/18F-FDG PET imaging classification holds high prognostic value in patients with metastatic gastroenteropancreatic neuroendocrine neoplasias.



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