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Title: Long-Acting Somatostatin Analog Therapy Differentially Alters 68Ga-DOTATATE Uptake in Normal Tissues Compared with Primary Tumors and Metastatic Lesions.
Austin Authors: Ayati, Narjess ;Lee, Sze Ting ;Zakavi, Rasoul;Pathmaraj, Kunthi ;Al-Qatawna, Louai;Poon, Aurora;Scott, Andrew M 
Affiliation: Nuclear Medicine Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
School of Cancer Medicine, La Trobe University, Melbourne, Australia
Nuclear Medicine Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
Nuclear Medicine and Cyclotron Unit, King Hussein Medical Center, Jordanian Royal Medical Services, Amman, Jordan
Issue Date: Feb-2018 2017-07-20
Publication information: Journal of nuclear medicine : official publication, Society of Nuclear Medicine 2018; 59(2): 223-227
Abstract: Synthetic somatostatin analogs have been posed as a potential source of error in somatostatin receptor imaging through interference with tumor detection; however, experimental models and clinical studies have shown a complex mechanism of the effect of octreotide on tumors. The aim of this study was to assess whether 68Ga-DOTATATE uptake before treatment with long-acting somatostatin analogs differs from that after treatment. Methods: Thirty patients (15 men; age [mean ± SD], 64.6 ± 13.4 y) who had intermediately differentiated to well-differentiated neuroendocrine tumors and who underwent 68Ga-DOTATATE PET/CT scanning before and after receiving long-acting repeatable octreotide (Sandostatin LAR) were included in the study. The SUVmax and SUVmean of healthy target organs, residual primary tumor, and up to 5 lesions with the highest SUVmax in each organ were compared before and after octreotide treatment. Results: The mean time interval between the 2 68Ga-DOTATATE studies was 9.6 ± 7.2 mo, and the mean time gap between the last Sandostatin LAR injection and the second 68Ga-DOTATATE study was 25.1 ± 14.8 d. The pretreatment mean SUVmax and SUVmean were both significantly higher in the thyroid, liver, and spleen (P < 0.05) than the values measured after the administration of Sandostatin LAR. No significant differences were found among the uptake indices for residual primary tumor or any metastatic lesions in the liver, bone, lung, or lymph nodes before and after Sandostatin LAR administration (P > 0.05). Conclusion: Long-acting octreotide treatment diminished 68Ga-DOTATATE uptake in the liver, spleen, and thyroid but did not compromise tracer uptake in residual primary tumor and metastatic lesions. These findings have a direct impact on the interpretation of 68Ga-DOTATATE PET/CT scans.
DOI: 10.2967/jnumed.117.192203
ORCID: 0000-0002-6656-295X
PubMed URL: 28729431
Type: Journal Article
Subjects: 68Ga-DOTATATE
neuroendocrine tumor
somatostatin analogs
somatostatin receptor imaging
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