Role of 68Ga-DOTATOC PET-CT in the diagnosis and staging of pancreatic neuroendocrine tumours

The objective of the present study was to evaluate the role of Ga-68-DOTA(0)-Phe(1)-Tyr(3)-octreotide (Ga-68-DOTATOC) positron emission tomography computed tomography (PET-CT) for detection and staging of pancreatic neuroendocrine tumours (NETs). Twenty patients with clinically suspected and/or histopathologically proven pancreatic NET underwent Ga-68-DOTATOC PET-CT imaging for staging and /or localisation of primary lesion. They also underwent contrast enhanced CT (CECT) and 8 patients underwent F-18-FDG PET-CT. SUVmax of primary and metastatic lesions were measured. Results were verified with histopathology for primary tumour and with clinical follow up/MRI and /or biopsy for metastatic disease. Results of Ga-68-DOTATOC PET-CT were compared to CECT and F-18-FDG PET-CT. Ga-68-DOTATOC PET-CT correctly localised primary in all 20, CECT in 15 and F-18-FDG PET-CT in 2 patients. Ga-68-DOTATOC PET-CT demonstrated metastases in 13 patients, CECT in 7 and F-18-FDG PET-CT in 2. Ga-68-DOTATOC PET-CT emerged as the best investigation with 100% sensitivity and PPV for detecting primary tumour and metastatic disease. The detection rate of CECT was lower than Ga-68-DOTATOC PET-CT, both for primary tumour (20vs.15) or metastatic disease (13vs.7). F-18-FDG PET-CT performed poorly for primary and metastasis. Ga-DOTATOC PET-CT is a very useful imaging investigation for diagnosing and staging pancreatic NET.