Comparison of neuroendocrine tumor detection and characterization using DOTATOC-PET in correlation with contrast enhanced CT and delayed contrast enhanced MRI

• Published in: European journal of radiology Vol. 81; no. 10; pp. 2820 - 2825
• Main Authors: Giesel, F.L, Kratochwil, C, Mehndiratta, A, Wulfert, S, Moltz, J.H, Zechmann, C.M, Kauczor, H.U, Haberkorn, U, Ley, S
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.10.2012
• Subjects: Comparison study; Contrast enhanced CT; Contrast enhanced MRI; Contrast Media - administration & dosage; Female; Gadolinium DTPA - administration & dosage; Gastroenteropancreatic neuroendocrine tumors; Gd-EOB-DTPA; Humans; Indium Radioisotopes; Iopamidol - administration & dosage; Iopamidol - analogs & derivatives; Magnetic Resonance Imaging - methods; Male; Metastatic liver lesions; Neuroendocrine Tumors - diagnosis; Octreotide - analogs & derivatives; PET-CT; Positron-Emission Tomography - methods; Radiology; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Statistics as Topic; Tomography, X-Ray Computed - methods; GEP-NETs; Metastatic liver lesions; DOTATOC; DOTA-Phe-Tyr-octreotide; PET-CT; Gd-EOB-DTPA; Contrast enhanced MRI; gastroenteropancreatic neuroendocrine tumors; Contrast enhanced CT; Comparison study; Gastroenteropancreatic neuroendocrine tumors
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2011.11.007

Abstract Purpose We evaluated the rate of successful characterization of gastroenteropancreatic neuroendocrine tumors (NETs) present with an increased somatostatin receptor, comparing CE-CT with CE-MRI, each in correlation with DOTATOC-PET. Methods and materials 8 patients with GEP-NET were imaged using CE-MRI (Gd-EOB-DTPA), CE-CT (Imeron 400) and DOTATOC-PET. Contrast-enhancement of normal liver-tissue and metastasis was quantified with ROI-technique. Tumor delineation was assessed with visual-score in blind-read-analysis by two experienced radiologists. Results Out of 40 liver metastases in patients with NETs, all were detected by CE-MRI and the lesion extent could be adequately assessed, whereas CT failed to detect 20% of all metastases. The blind-read-score of CT in arterial and portal phase was median −0.65 and −1.4, respectively, and 2.7 for delayed-MRI. The quantitative ROI-analysis presented an improved contrast-enhancement-ratio with a median of 1.2, 1.6 and 3.3 for CE-CT arterial, portal-phase and delayed-MRI respectively. Conclusion Late CE-MRI was superior to CE-CT in providing additionally morphologic characterization and exact lesion extension of hepatic metastases from neuroendocrine tumor detected with DOTATOC-PET. Therefore, late enhanced Gd-EOB-DTPA-MRI seems to be the adequate imaging modality for combination with DOTATOC-PET to provide complementary (macroscopic and molecular) tumor characterization in hepatic metastasized NETs.