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J Nucl Med. 2016 Jun;57(6):872-8. doi: 10.2967/jnumed.115.165803. Epub 2016 Jan 14.

68Ga-DOTATATE Compared with 111In-DTPA-Octreotide and Conventional Imaging for Pulmonary and Gastroenteropancreatic Neuroendocrine Tumors: A Systematic Review and Meta-Analysis.

Author information

1
Veterans Affairs Hospital, Tennessee Valley Healthcare System, Nashville, Tennessee Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee Vanderbilt-Ingram Cancer Center, Nashville, Tennessee.
2
Department of Biostatistics, Vanderbilt University, Nashville, Tennessee.
3
Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio.
4
Veterans Affairs Hospital, Tennessee Valley Healthcare System, Nashville, Tennessee Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
5
Department of Radiology, University of Iowa, Iowa City, Iowa; and.
6
Knowledge Management, Eskind Biomedical Library, Vanderbilt University Medical Center, Nashville, Tennessee.
7
Vanderbilt-Ingram Cancer Center, Nashville, Tennessee Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
8
Veterans Affairs Hospital, Tennessee Valley Healthcare System, Nashville, Tennessee Vanderbilt-Ingram Cancer Center, Nashville, Tennessee Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee ronald.walker@vanderbilt.edu.

Abstract

Neuroendocrine tumors (NETs) are uncommon tumors with increasing incidence and prevalence. Current reports suggest that (68)Ga-DOTATATE PET/CT imaging improves diagnosis and staging of NETs compared with (111)In-DTPA-octreotide and conventional imaging. We performed a systematic review of (68)Ga-DOTATATE for safety and efficacy compared with octreotide and conventional imaging to determine whether available evidence supports U.S. Food and Drug Administration approval.

METHODS:

Medline, EMBASE, Web of Science, and Cochrane Reviews electronic databases were searched from January 1999 to September 2015. Results were restricted to human studies comparing diagnostic accuracy of (68)Ga-DOTATATE with octreotide or conventional imaging for pulmonary or gastroenteropancreatic NET and for human studies reporting safety/toxicity for (68)Ga-DOTATATE with 10 subjects or more thought to have NETs. Direct communication with corresponding authors was attempted to obtain missing information. Abstracts meeting eligibility criteria were collected by a research librarian and assembled for reviewers; 2 reviewers independently determined whether or not to include each abstract. If either reviewer chose inclusion, the abstract was accepted for review.

RESULTS:

Database and bibliography searches yielded 2,479 articles, of which 42 were eligible. Three studies compared the 2 radiopharmaceuticals in the same patient, finding (68)Ga-DOTATATE to be more sensitive than octreotide. Nine studies compared (68)Ga-DOTATATE with conventional imaging. (68)Ga-DOTATATE estimated sensitivity, 90.9% (95% confidence interval, 81.4%-96.4%), and specificity, 90.6% (95% confidence interval, 77.8%-96.1%), were high. Five studies were retained for safety reporting only. Report of harm possibly related to (68)Ga-DOTATATE was rare (6 of 974), and no study reported major toxicity or safety issues.

CONCLUSION:

No direct comparison of octreotide and (68)Ga-DOTATATE imaging for diagnosis and staging in an unbiased population of NETs has been published. Available information in the peer-reviewed literature regarding diagnostic efficacy and safety supports the use of (68)Ga-DOTATATE for imaging of NETs where it is available.

KEYWORDS:

DOTATATE; meta-analysis; neuroendocrine; octreotide; pentetreotide; systematic review

PMID:
26769864
PMCID:
PMC5362941
DOI:
10.2967/jnumed.115.165803
[Indexed for MEDLINE]
Free PMC Article

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