68Ga-DOTATATE PET imaging in clinically non-functioning pituitary macroadenomas

European Journal of Hybrid Imaging, vol. 4, pp. 4

Abstract

Abstract Purpose Clinically non-functioning pituitary macroadenomas (NFMA) have been reported to express somatostatin receptors (SSTR), but results are inconsistent across different studies. This may be related to limited sensitivity and specificity of techniques used to date, i.e. immunohistochemistry in surgical specimens and 111In-DTPA-octreotide scintigraphy in vivo. The aim of this study was to assess SSTR expression in NFMA in vivo using 68Ga-DOTATATE PET, which offers superior sensitivity and spatial resolution as compared with planar scintigraphy or SPECT. Methods Thirty-seven patients diagnosed with NFMA underwent 68Ga-DOTATATE PET/CT of the head in the framework of a randomised controlled trial assessing the effect of the somatostatin analogue lanreotide on NFMA size. Individual co-registered T1-weighted pituitary MRIs were used to assess 68Ga-DOTATATE uptake (SUVmean) in the adenoma. An SUVmean of > 2 was considered positive. Results 68Ga-DOTATATE uptake was positive in 34/37 patients (92%), with SUVmean of positive adenomas ranging from 2.1 to 12.4 (mean ± SD 5.8 ± 2.6). Conclusions This is the first report of 68Ga-DOTATATE PET performed in NFMA patients, demonstrating in vivo SSTR expression in the vast majority of cases. The high positivity rate when compared with results obtained with 111In-DTPA-octreotide scintigraphy probably reflects the superior sensitivity of PET imaging. Trial registration Netherlands Trial Register, NL5136 , registered on 18 August 2015; EudraCT, 2015-001234-22, registered on 10 March 2015, https://eudract.ema.europa.eu/

Authors 11

1. Tessel M. Boertien corresponding

   Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands. t.m.boertien@amsterdamumc.nl

   Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands

2. Jan Booij

   Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands

3. Charles B.L.M. Majoie

   Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands

4. Madeleine L. Drent

   Amsterdam University Medical Centers · Amsterdam UMC Location Vrije Universiteit Amsterdam

   Affiliation as printed

   Department of Internal Medicine, Section of Endocrinology, Amsterdam UMC, VU University, De Boelelaan 1117, Amsterdam, the Netherlands

5. Alberto M. Pereira Aachen Department of Medicine Division of Endocrinology, and Center for Endocrine Tumors Leiden

   Leiden University Medical Center

   Affiliation as printed

   Department of Medicine, Division of Endocrinology, and Center for Endocrine Tumors Leiden (CETL), Leiden University Medical Center, Leiden, the Netherlands

6. Nienke Ruurdje Biermasz Aachen Department of Medicine Division of Endocrinology, and Center for Endocrine Tumors Leiden

   Leiden University Medical Center

   Affiliation as printed

   Department of Medicine, Division of Endocrinology, and Center for Endocrine Tumors Leiden (CETL), Leiden University Medical Center, Leiden, the Netherlands

7. Suat Şimşek

   Noordwest Ziekenhuisgroep · Amsterdam University Medical Centers · Amsterdam UMC Location Vrije Universiteit Amsterdam

   Affiliation as printed

   Department of Internal Medicine, Northwest Clinics, Alkmaar, the Netherlands

   Department of Internal Medicine, Section of Endocrinology, Amsterdam UMC, VU University, De Boelelaan 1117, Amsterdam, the Netherlands

8. Ronald Groote Veldman

   Medisch Spectrum Twente

   Affiliation as printed

   Department of Internal Medicine, Medical Spectrum Twente, Enschede, the Netherlands

9. Marcel P. M. Stokkel

   The Netherlands Cancer Institute

   Affiliation as printed

   Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, the Netherlands

10. Peter H L T Bisschop

    Amsterdam University Medical Centers · University of Amsterdam

    Affiliation as printed

    Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands

11. Eric Fliers

    Amsterdam University Medical Centers · University of Amsterdam

    Affiliation as printed

    Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands