Somatostatin receptor imaging with [68Ga]Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) in patients with nasopharyngeal carcinoma

• Published in: European journal of nuclear medicine and molecular imaging Vol. 49; no. 4; pp. 1360 - 1373
• Main Authors: Zhao, Liang, Pang, Yizhen, Wang, Yuhuan, Chen, Jianhao, Zhuang, Yanzhen, Zhang, Jingjing, Zhao, Long, Sun, Long, Wu, Hua, Chen, Xiaoyuan, Lin, Qin, Chen, Haojun
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2022; Springer Nature B.V
• Subjects: Brain tumors; Cardiology; Computed tomography; Diagnostic systems; Fluorine isotopes; Fluorodeoxyglucose F18; Gallium Radioisotopes; Humans; Image contrast; Imaging; Lesions; Lymph nodes; Medical imaging; Medicine; Medicine & Public Health; Metastases; Metastasis; Nasopharyngeal carcinoma; Nasopharyngeal Carcinoma - diagnostic imaging; Nasopharyngeal Neoplasms - diagnostic imaging; Neuroimaging; Nuclear Medicine; Oncology; Oncology – Head and Neck; Organometallic Compounds; Original Article; Orthopedics; Positron emission; Positron emission tomography; Positron Emission Tomography Computed Tomography - methods; Prospective Studies; Radioactive tracers; Radiology; Radionuclide Imaging; Radiopharmaceuticals; Receptors; Receptors, Somatostatin - metabolism; Somatostatin; Somatostatin receptors; Throat cancer; Tomography; Nasopharyngeal carcinoma; SUVmax; [; SSTR2; Ga]Ga-DOTATATE; PET/CT; [68Ga]Ga-DOTATATE
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-021-05587-7

Purpose To explore the feasibility of [ 68 Ga]Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) in patients with non-keratinizing nasopharyngeal carcinoma (NPC) and to evaluate whether [ 68 Ga]Ga-DOTATATE PET/CT could be used for non-invasive determination of somatostatin receptor 2 (SSTR2) expression in NPC. Methods This prospective study included patients with NPC who underwent [ 68 Ga]Ga-DOTATATE PET/CT between February and May 2021. The [ 68 Ga]Ga-DOTATATE and [ 18 F]FDG uptakes in primary and metastatic NPC lesions were calculated and compared, and the [ 68 Ga]Ga-DOTATATE uptake between SSTR2 score groups was analysed. Results A total of 36 participants (25 patients, initial staging; 11 patients, recurrence detection) were included; 33 patients also underwent [ 18 F]FDG PET/CT for staging/restaging as a part of their routine diagnostic workup. [ 68 Ga]Ga-DOTATATE PET/CT showed an intense tracer uptake in primary and metastatic NPC lesions. The radiotracer uptake was higher with [ 68 Ga]Ga-DOTATATE than with [ 18 F]FDG PET in primary NPC lesions (SUVmax: 12.03 vs. 10.07, P  = 0.048; tumour-to-brain ratio: 36.16 vs . 0.86, P  < 0.001) and regional lymph node metastases (median SUVmax: 9.11 vs. 6.12, P < 0.001) and comparable in bone and visceral metastases. Importantly, most NPC lesions showed intense SSTR2 expression (85.7%), which was strongly correlated with the [ 68 Ga]Ga-DOTATATE uptake. The SUVmax of SSTR2-negative lesions was significantly lower than that of SSTR2-positive lesions (SUVmax: 4.95 vs . 12.61, P  = 0.013). Conclusion [ 68 Ga]Ga-DOTATATE PET/CT is a promising imaging modality for detecting primary and metastatic NPC, with favourable image contrast and comparable diagnostic efficacy when compared to [ 18 F]FDG PET/CT. An intense SSTR2 expression was observed in most NPCs, and this expression was significantly correlated with the [ 68 Ga]Ga-DOTATATE uptake.