PET offers more precise screening method to select candidates for radionuclide therapy

ScienceDaily | 10/8/2019 | Staff
"In the past, physicians relied on 111In-pentetreotide imaging with planar scintigraphy and single photon emission computed tomography (SPECT) to determine whether or not a patient is eligible to receive 177Lu-DOTATATE PRRT," said Thomas A. Hope, MD, associate professor of radiology at the University of California, San Francisco. "However, limited literature is available on the accuracy of PET/CT in determining 177Lu-DOTATATE PRRT eligibility. Our study aimed to compare the Krenning scores derived from the various imaging modalities and assess the impact on treatment decision-making."

The Krenning score is a relatively simple and reproducible method based on nuclear imaging used by physicians to make a quantitative estimate of the expression of somatostatin receptors (SSTR) in patients with neuroendocrine tumors. "Nuclear medicine physicians grade visually the uptake of the radiopharmaceutical in target lesions as compared to the uptake in the liver. This visual assessment is based on the target lesion with the highest uptake," said Jeremie Calais, MD, assistant professor of nuclear medicine and theranostics at the University of California, Los Angeles. Hope added, "The higher the Krenning score, the higher the predicted uptake of the targeted therapy."

Retrospective - Study - Patients - Suspicion - Evidence

The retrospective study included 150 patients with suspicion of or biochemical evidence of neuroendocrine tumors. Patients underwent both 68Ga-DOTATATE PET/CT and 111In-pentetreotide imaging (planar scintigraphy and SPECT) within a span of less than one week. Three physician readers independently analyzed all imaging studies and graded them using the Krenning score based on the lesion with the highest uptake. The studies were reviewed after grading, and a consensus grade was created for each study. The volume and extent of tumor burden, lesion size and maximum standardized uptake value also were measured and compared with the Krenning scores.

Based on the Krenning score, the detection rate of SSTR-positive disease was 23 percent, 38 percent and 72...
(Excerpt) Read more at: ScienceDaily
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