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G. Karimundackal

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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      77P - Is there an incremental benefit with 68 Ga DOTA PET/CT in staging of broncho-pulmonary carcinoid tumors? (ID 615)

      12:30 - 13:00  |  Presenting Author(s): G. Karimundackal

      • Abstract

      The staging of well differentiated bronchopulmonary neuroendocrine tumours (carcinoids) is complicated by the unpredictable incidence of nodal and distal metastases. PET CECT which has become the standard for staging of lung cancers has proven ineffective in the staging of carcinoid tumours. 68 Ga DOTA NOC PET/CT which depends on radio-tracer uptake in somatostatin receptors appears to be an attractive modality for the staging of these neuroendocrine tumours.

      We performed a retrospective analysis of patients who underwent 68 Ga DOTA NOC PET/CT followed by surgical resection from October 2014 to November 2017. Data was retrieved regarding demographics, standardized uptake value (SUV), surgery performed and final histopathology report including degree of differentiation, nodal positivity and Mib index. The study included only patients who underwent resection since the focus of the study on corelation with histopathological features. An attempt was made to corelate the SUV with diagnosis of typical vs atypical carcinoid, nodal metastases and Mib index.

      During the study period 38 patients underwent surgical resection following DOTA PET. All details of imaging including SUV were available for 35 patients, while complete histopathological details were available for 37 patients. DOTA PET was not able to differentiate between typical and atypical carcinoids (32 vs 3) based on SUV. The mean SUV of typical carcinoids was 41.4(SD- 41.2) whereas that of atypical carcinoids was 34.4(SD-39.4) and the difference was not statistically significant (p = 0.7). 6/37 cases had nodal metastases of which DOTA PET could corrrectly identify only 1. There were 2 false positive reports and 5 false negative reports, (sensitivity 16.6% and specificity 93.5%). The mean SUV of the false positive nodes (n = 2 cases) was 7 which calls into question the specificity of the tracer. No corelation between SUV and Mib index could be demonstrated, p = 0.37.

      In this study 68 Ga DOTA NOC PET CECT could not help in predicting the histopathological nature of carcinoid tumours, atypical vs typical, presence of nodal metastases or Mib index. This study is limited by the small numbers enrolled, a larger series may help us incoming to a more definitive conclusion.

      Clinical trial identification:

      Legal entity responsible for the study:
      Tata Memorial Hospital

      Has not received any funding

      The author has declared no conflicts of interest.