Author of

• 12791

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  P3.19 - Poster Session 3 - Imaging (ID 181)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Imaging, Staging & Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12802

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    P3.19-011 - The role of 18F-FDG PET/CT and 68Ga-DOTANOC PET/CT in differentiating typical<br /> and atypical pulmonary carcinoids (ID 1934)

    09:30 - 09:30  |  Author(s): G. Perotti
    • Abstract

    Background
    Pulmonary carcinoids are histologically classified into typical and atypical. It is important to identify these preoperatively for treatment planning and prognosis. Our purpose was to calculate the diagnostic sensibility of positron emission tomography/computed tomography (PET/CT) using two different tracers ([18]Fluorine-fluorodeoxyglucose [FDG], a glucose analogue and [68]Gallium-DOTANOC, a somatostatin analogue) in a series of patients with suspected bronchial carcinoids (BCs). Additionally, we have evaluated the combination of dual tracer PET/CT findings in differentiating typical and atypical pulmonary carcinoids.

    Methods
    Forty-four patients (16 male/28 female; mean age: 57.8 y.o.) with suspected BCs (based on radiological findings) underwent PET/CT with FDG and [68]Gallium-DOTANOC in 2 high-volume centers. Detection rates of BCs on a per patient-based analysis were calculated. Histology was used as reference standard. The Chi-square test was used to correlate histology and PET findings.

    Results
    After surgery, 23 typical carcinoids (TCs), 10 atypical carcinoids (ATCs) and 11 benign pulmonary lesions (amartomas) were found. Overall and histology-based sensibility rates of both PET-methods are shown in Table. In particular, no false positive results were found and the overall detection rate for BCs was 100% when combining both PET methods (one positive at least). DOTANOC-PET/CT is superior in detecting TCs (sensibility= 91.3%) while FDG-PET/CT seems to be more useful in ATCs (sensibility= 100%). A significant association between histological type and PET findings with the two tracers was found (p<0.05). Moreover, the ratio of SUVmax values (DOTANOC/FDG) was significantly higher in TC-group when compared with ATC-group (10.00 vs 0.90; p= 0.027) Figure 1

    Conclusion
    Overall diagnostic performance of PET-CT in detecting BCs is optimal when integrating dual tracer PET-CT findings (FDG and DOTANOC). The combination of dual tracer PET/TC findings and the ratio of SUVmax values (DOTANOC/FDG) may be useful in differentiating TCs and ATCs. Therefore, both PET/CT methods should be performed in suspected BCs or when the histological subtype of BCs is unknown.