The utility of 68Gallium-DOTATATE PET/CT in the detection of von Hippel-Lindau disease associated tumors

Publication date: Available online 22 November 2018

Source: European Journal of Radiology

Author(s): Jasmine Shell, Amit Tirosh, Corina Millo, Samira M. Sadowski, Yasmine Assadipour, Patience Green, Dhaval Patel, Naris Nilubol, Electron Kebebew

Abstract

Purpose

Patients with von Hippel-Lindau (VHL) disease may develop various tumors, including neuroendocrine tumors of the pancreas (PNETs) and adrenal, central nervous system hemangioblastomas, kidney tumors and more. ⁶⁸Ga-DOTATATE positron emission tomography (PET)/computerized tomography (CT) has been shown to be highly accurate for tumors with somatostatin receptors. We aimed to assess the performance of ⁶⁸Ga-DOTATATE PET/CT in patients with VHL disease.

Methods

Patients with a diagnosis of VHL were enrolled in a prospective study and underwent surveillance imaging for pancreatic lesions (n = 301). The current analysis includes 73 evaluations with multiple imaging modalities of 36 patients (2.1 ± 0.8 evaluations/patient, range 1-4) for a head-to-head comparison of ⁶⁸Ga-DOTATATE PET/CT, CT and/or MRI. In this post-hoc analysis we compared the detection rates of various imaging modalities for pancreatic NET (PNETs) and for any extrapancreatic tumors located within the scan field of CT/MRI abdomen.

Results

⁶⁸Ga-DOTATATE PET/CT detected a total of 206 lesions, CT detected 208 lesions and MRI detected 94 lesions in 66, 31 and 66 scans, respectively. ⁶⁸Ga-DOTATATE PET/CT (3.4 ± 0.1 per scan) was superior than CT (3.2 ± 0.1 per scan, p = 0.02) with a similar trend when comparing with MRI (2.8 ± 0.1 per scan, p = 0.03) in detecting lesions in any anatomic locations.

Conclusions

⁶⁸Ga-DOTATATE PET/CT had a significantly higher detection rate when compared with anatomic imaging for all lesions, and comparable detection rate for pancreatic lesions in VHL patients. Hence, given the higher accuracy and lower radiation exposure associated with ⁶⁸Ga-DOTATATE PET/CT, its potential role in the surveillance of VHL-associated lesions should be further studied.

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