Patrick Veit-Haibach MD, Presenter: Nothing to Disclose

Marc Schiesser MD, Abstract Co-Author: Nothing to Disclose

Jan David Soyka MD, Abstract Co-Author: Nothing to Disclose

Klaus Strobel MD, Abstract Co-Author: Nothing to Disclose

Thomas F. Hany MD, Abstract Co-Author: Nothing to Disclose

To assess prospectively the diagnostic accuracy and therapeutic influence of a WB DOPA-PET/CT with integrated triple-phase contrast enhancement (cePET/CT) in patients with neuroendocrine tumors.

65 patients (30 male, 35 female, mean age: 55.8 years) with suspected or known neuroendocrine tumors underwent a DOPA-cePET/CT. The DOPA-PET-data, ceCT-data and combined cePET/CT-data were evaluated by two dual accredited radiologist/nuclear medicine specialists and diagnostic accuracies and their influence on therapy were compared. Sensitivities (sens.), specificities (spec.), accuracies (acc.), negative (NPV) and positive predictive values (PPV) were calculated on a lesion-bases analysis, as well as on a region-based and patient-based analysis. Histopathology from biopsies, surgery as well as clinical follow-up (mean time: 12.6 month) served as the standard of reference. Therapeutic influence of the cePET/CT examination was prospectively determined based on the therapeutic procedures introduced by the findings of the DOPA-cePET/CT. Differences between the procedures were tested for statistical significance by McNemar’s test.

In 25 Patients no suspicious lesions were found, in 40 patients metastastic and/or primary tumor lesions (32 patients with histopathological verification) were detected by the DOPA-cePET/CT. Lesion-based analysis for the PET-data showed Sens., Spec, Acc., NPV and PPV of 66%, 100%, 67%, 10% and 100%, for the ceCT-data 85%, 71%, 85%, 14% and 99% and for the combined cePET/CT-data 97%, 71%, 96%, 42% and 99%. CeCT found significantly (p<0.05) more lesions than PET-alone and the combined DOPA cePET/CT was significantly superior compared to ceCT (p<0.05) and PET-alone (p<0.05). Overall, eight primary tumors were found (12%), 5 of those (8%) were previously unknown. In 17 patients (26%), the therapy regimen was prospectively changed based on the DOPA-cePET/CT findings.

The combined DOPA cePET/CT was significantly superior compared to PET-alone and ceCT alone. Furthermore, in every fourth (26%) patient, the therapeutic regimen was altered prospectively based on our imaging findings. Thus, DOPA cePET/CT has the potential to further improve staging and consecutive therapy in patients with neuroendocrine tumors.

DOPA cePET/CT has the potential to further improve staging and consecutive therapy in patients with neuroendocrine tumors.

Veit-Haibach, P, Schiesser, M, Soyka, J, Strobel, K, Hany, T, Diagnostic Accuracy and Therapeutic Influence of Triple-Phase Contrast-enhanced DOPA-PET/CT in Patients with Neuroendocrine Tumors.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8015675.html