⁶⁸Ga-DOTATATE PET/CT versus MRI in neuroendocrine liver metastases: a comprehensive per-lesion analysis.

IF 4.8 1区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Radiologia Medica Pub Date : 2025-09-11 DOI:10.1007/s11547-025-02080-1

Alexander Herold, Azadeh Hajati, Yihan Cao, Kevin P Fialkowski, Soumyadeep Ghosh, Francis Delaney, Vrushab Gowda, Pedram Heidari, Shadi A Esfahani, Mukesh G Harisinghani, Luigi Asmundo, Lucian Beer, Valeria Peña-Trujillo, Samantha G Harrington, Steven Stufflebeam, Bruce R Rosen, Michael Weber, Susie Y Huang, Onofrio A Catalano

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Abstract

Purpose: To evaluate the diagnostic performance of ⁶⁸Ga-DOTATATE PET, contrast-enhanced CT, combined DOTATATE PET/CT, and MRI in detecting neuroendocrine liver metastases on a per-lesion basis and to assess the added value of diagnostic contrast-enhanced CT to PET interpretation as well as influence of lesion size.

Materials and methods: This retrospective study evaluated patients with histologically-confirmed gastroenteropancreatic neuroendocrine tumors who underwent both contrast-enhanced MRI and ⁶⁸Ga-DOTATATE PET/CT within 12 weeks between August 2017 and December 2023. Three readers evaluated in consensus MRI, ⁶⁸Ga-DOTATATE PET, contrast-enhanced CT, and combined PET/CT in separate sessions. Lesions were stratified by size. Diagnostic performance metrics were calculated using generalized estimating equations with reference standard of imaging follow-up or histopathology.

Results: The study included 36 patients (mean age 66.4 ± 10.7 years, 55.6% male) with 720 lesions, of which 582 were metastases. MRI demonstrated superior performance (sensitivity 94.0%, specificity 94.2%) compared to all other modalities (all p < .001). Combined PET/CT showed superior sensitivity (68.1%) compared to PET alone (61.1%) (p < .001). The addition of diagnostic contrast-enhanced CT to PET interpretation identified 41 additional metastases. Size-stratified analysis revealed superior detection of subcentimeter lesions by MRI (sensitivity 83.3% for ≤ 5 mm, 99.6% for 6-10 mm) compared to PET/CT (34.8% and 78.6%, respectively; p < .001). For lesions > 10 mm, both MRI and PET/CT achieved 100% sensitivity, while PET alone reached 94.1% (p = .019).

Conclusion: MRI outperforms ⁶⁸Ga-DOTATATE PET/CT in detecting individual neuroendocrine liver metastases, particularly for subcentimeter lesions. While diagnostic CT improves PET performance, the combination of MRI with ⁶⁸Ga-DOTATATE PET/CT provides the most comprehensive assessment.

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68Ga-DOTATATE PET/CT与MRI在神经内分泌性肝转移中的对比分析

目的：评价68Ga-DOTATATE PET、增强CT、DOTATATE PET/CT联合MRI对神经内分泌性肝转移病灶的诊断价值，评估增强CT对PET诊断的附加价值及病灶大小的影响。材料和方法：本回顾性研究评估了2017年8月至2023年12月12周内接受MRI增强和68Ga-DOTATATE PET/CT检查的经组织学证实的胃肠胰神经内分泌肿瘤患者。三位读者分别在MRI、68Ga-DOTATATE PET、对比增强CT和PET/CT联合检查中进行评估。病变按大小分层。采用广义估计方程计算诊断性能指标，参照影像学随访或组织病理学标准。结果：本组36例患者（平均年龄66.4±10.7岁，男性55.6%），病变720个，其中转移582个。与所有其他方式(p均为10 mm， MRI和PET/CT均达到100%的灵敏度，而PET单独达到94.1% （p = 0.019）相比，MRI表现出优越的性能（灵敏度94.0%，特异性94.2%）。结论：MRI在检测个体神经内分泌性肝转移方面优于68Ga-DOTATATE PET/CT，尤其是亚厘米病变。虽然诊断性CT提高了PET的表现，但MRI与68Ga-DOTATATE PET/CT的结合提供了最全面的评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiologia Medica 医学-核医学

CiteScore

14.10

自引率

7.90%

发文量

133

审稿时长

4-8 weeks

期刊介绍： Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.