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
{"title":"68Ga-DOTATATE PET/CT与MRI在神经内分泌性肝转移中的对比分析","authors":"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","doi":"10.1007/s11547-025-02080-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic performance of <sup>68</sup>Ga-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.</p><p><strong>Materials and methods: </strong>This retrospective study evaluated patients with histologically-confirmed gastroenteropancreatic neuroendocrine tumors who underwent both contrast-enhanced MRI and <sup>68</sup>Ga-DOTATATE PET/CT within 12 weeks between August 2017 and December 2023. Three readers evaluated in consensus MRI, <sup>68</sup>Ga-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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>MRI outperforms <sup>68</sup>Ga-DOTATATE PET/CT in detecting individual neuroendocrine liver metastases, particularly for subcentimeter lesions. While diagnostic CT improves PET performance, the combination of MRI with <sup>68</sup>Ga-DOTATATE PET/CT provides the most comprehensive assessment.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":4.8000,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"<sup>68</sup>Ga-DOTATATE PET/CT versus MRI in neuroendocrine liver metastases: a comprehensive per-lesion analysis.\",\"authors\":\"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\",\"doi\":\"10.1007/s11547-025-02080-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate the diagnostic performance of <sup>68</sup>Ga-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.</p><p><strong>Materials and methods: </strong>This retrospective study evaluated patients with histologically-confirmed gastroenteropancreatic neuroendocrine tumors who underwent both contrast-enhanced MRI and <sup>68</sup>Ga-DOTATATE PET/CT within 12 weeks between August 2017 and December 2023. Three readers evaluated in consensus MRI, <sup>68</sup>Ga-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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>MRI outperforms <sup>68</sup>Ga-DOTATATE PET/CT in detecting individual neuroendocrine liver metastases, particularly for subcentimeter lesions. While diagnostic CT improves PET performance, the combination of MRI with <sup>68</sup>Ga-DOTATATE PET/CT provides the most comprehensive assessment.</p>\",\"PeriodicalId\":20817,\"journal\":{\"name\":\"Radiologia Medica\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-09-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiologia Medica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11547-025-02080-1\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiologia Medica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11547-025-02080-1","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
68Ga-DOTATATE PET/CT versus MRI in neuroendocrine liver metastases: a comprehensive per-lesion analysis.
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.
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.
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