Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2018) 60 P18 | DOI: 10.1530/endoabs.60.P18

1University Hospital Aintree, Liverpool, UK; 2Christie Hospital, Manchester, UK; 3King’s College Hospital, London, UK; 4Royal Liverpool University Hospital, Liverpool, UK; 5Royal Liverpool University Hospital, London, UK.


Background: Pancreatic neuroendocrine tumours (panNETs) are rare tumours (prevalence 4/100,000). Diagnosis and staging of panNETs requires biochemical screening, cross-sectional imaging (with CT/MRI), endoscopic ultrasound (EUS) and where available, functional imaging using 68Ga-labelled synthetic octreotide analogues using PET-CT due to its reported higher sensitivity and specificity.

Methods: A retrospective, electronic case note study was carried out across three ENETS Centres (Liverpool, Aintree, Royal Liverpool; The Christie, Manchester; and King’s College Hospital, London) to investigate the effect of 68Ga-based PET-CT imaging on patient management, in patients with a clinically-suspected or histologically-confirmed sporadic panNET. Patients who had undergone a 68Ga-based PET-CT scan for a panNET were identified using a prospectively populated list.

Results: A total of 172 patients were identified between 2014 and 2018; 52% male, 48% female; with a median age of 68 years (range 13–89). Of these 90% (n=153) were still alive (17 (10%) had died; 2(1%) missing data); 83% (n=132) had non-functional tumours (based on their biochemical profile) and 17% (n=27) had functional tumours (8%, 13 missing data). A confirmed histological diagnosis (from either biopsy/surgical resection) was available in 91% of patients (n=156) with imaging only in the remainder. Of patients with histology available 51% (n=73) were Grade (G)1 tumours, 46% (n=66) were G2 and 3% (n=5) were G3; 55% (n=93) had localised disease; 18% (n=31) were locally advanced and 27% (n=46) were metastatic. Indications for performing a 68Ga-PET-CT included diagnosis and staging 36% (n=62), consideration for peptide receptor radionuclide therapy (PRRT) 9% (n=15) and post-operative assessment or clinical surveillance to look for disease recurrence 55% (n=93). In 54% of cases (n=75) the evidence provided by the gallium scan was confirmatory and consistent with other imaging findings, in 12% (n=17) it resulted in a change of treatment and in 28% (n=39) new sites of disease were identified not evident with other imaging techniques. Overall it was deemed to result in a change in management in 39% of cases.

Conclusion: 68Ga-based PET-CT imaging in patients with panNETs changes clinical management in 39% of cases by providing supplementary information informing the diagnosis, staging, most appropriate treatment modality and subsequent monitoring of recurrence.

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