Volumetric 68Ga-DOTA-TATE PET/CT for assessment of whole-body tumor burden as a quantitative imaging biomarker in patients with metastatic gastroenteropancreatic neuroendocrine tumors.

Fiona Ohlendorf, Christoph Henkenberens, Thomas Brunkhorst, Tobias L Ross, Hans Christiansen, Frank M Bengel, Thorsten Derlin
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引用次数: 6

Abstract

Background: A quantitative imaging biomarker is desirable to provide a comprehensive measure of whole-body tumor burden in patients with metastatic neuroendocrine tumors, and to standardize the evaluation of treatment-related changes. Therefore, we evaluated volumetric parameters for quantification of whole-body tumor burden from somatostatin receptor (SSR)-targeted PET/CT.

Methods: Thirty-two patients with metastastic grade1/grade 2 gastroenteropancreatic neuroendocrine tumors who underwent a 68Ga-DOTA-TATE PET/CT for staging of disease before initiation of peptide receptor radionuclide therapy were included in this retrospective cohort analysis. Volumetric parameters of tumor lesions, SSR-derived tumor volume (SSR-TV) and total lesion SSR (TL-SSR), were calculated for each patient using a computerized volumetric technique with a 40% SUVmax cut-off, and compared with serum chromogranin A (CgA) levels. Progression-free survival (PFS) was determined in relation to volumetric parameters. In a subgroup of 18 patients, the feasibility of volumetric parameters for treatment monitoring was evaluated.

Results: Mean SSR-TV was 178±214 cm3 (range, 9-797 cm3), whereas mean TL-SSR was 4096±5191 cm3 (range, 61-19,203 cm3). Baseline CgA levels were associated with whole-body tumor burden (SSR-TV, r=0.57, P=0.0008; and TL-SSR, r=0.43, P=0.01, respectively). PFS was shorter in patients with high SSR-TV and high TL-SSR (HR 5.16, 95% CI, 1.61-29.67), P=0.009), and SSR-TV (P=0.0067) and TL-SSR (P=0.0215) emerged as the sole predictors of progression in regression analysis. Changes in CgA did not correctly identify treatment response (P=0.25).

Conclusions: SSR-derived volumetric parameters provide a quantitative imaging biomarker for whole-body tumor burden, and may hold potential as a clear-cut measure for assessment of treatment response.

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68Ga-DOTA-TATE体积PET/CT作为转移性胃肠胰神经内分泌肿瘤患者全身肿瘤负荷评估的定量成像生物标志物
背景:需要一种定量的成像生物标志物,以提供转移性神经内分泌肿瘤患者全身肿瘤负荷的综合测量,并标准化治疗相关变化的评估。因此,我们评估了利用生长抑素受体(SSR)靶向PET/CT定量全身肿瘤负荷的体积参数。方法:回顾性队列分析32例转移性1/ 2级胃肠胰神经内分泌肿瘤患者,这些患者在肽受体核素治疗开始前接受68Ga-DOTA-TATE PET/CT检查以确定疾病分期。采用计算机体积测量技术计算每位患者的肿瘤体积参数,SSR衍生肿瘤体积(SSR- tv)和病变总SSR (TL-SSR), SUVmax截断率为40%,并与血清嗜铬粒蛋白a (CgA)水平进行比较。无进展生存期(PFS)与体积参数相关。在18例患者的亚组中,评估了容量参数用于治疗监测的可行性。结果:平均SSR-TV为178±214 cm3(范围9 ~ 797 cm3),平均TL-SSR为4096±5191 cm3(范围61 ~ 19203 cm3)。基线CgA水平与全身肿瘤负荷相关(SSR-TV, r=0.57, P=0.0008;TL-SSR, r=0.43, P=0.01)。高SSR-TV和高TL-SSR患者的PFS较短(HR 5.16, 95% CI, 1.61 ~ 29.67), P=0.009),回归分析中SSR-TV (P=0.0067)和TL-SSR (P=0.0215)是唯一的进展预测因子。CgA的变化不能正确识别治疗反应(P=0.25)。结论:ssr衍生的体积参数提供了一种全身肿瘤负荷的定量成像生物标志物,可能作为评估治疗反应的明确指标。
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