UKINETS2018 Poster Presentations (1) (28 abstracts)
The impact of 68Ga-based PET-CT scanning on the management of patients with familial pancreatic neuroendocrine tumours (panNETs)
Daniel Cuthbertson 1 , Jorge Barriuso 2 , Michail Pizanias 3 , Matthew Jaffa 4 , Christina Nuttall 2 , Gillian Vivian 3 , Tom Halloran 1 , Tom Westwood 2 , Andreas Prachalias 3 , Fiona Lalloo 2 , Hulya Weismann 1 , Wendy Martin 3 , Sobhan Vinjamuri 4 , D. Mark Pritchard 4 , Steve Fenwick 1 , Paula Ganeh 4 , Mike Raraty 4 , Mairead McNamara 2 , Raj Srirajaskanthan 3 , John Ramage 3 , Prakash Manoharan 2 & Vincent Yip 4
1University Hospital Aintree, Liverpool, UK; 2The Christie, Manchester, UK; 3King’s College Hospital, London, UK; 4Royal Liverpool Hospital, Liverpool, UK.
Background: Pancreatic neuroendocrine tumours (panNETs) may arise as part of an underlying genetic condition such as multiple endocrine neoplasia type 1 (MEN type 1). The value of functional imaging using 68Ga-labelled synthetic octreotide analogues using PET-CT has not been extensively evaluated in patients with MEN1 to determine its value.
Methods: We investigated the effect of 68Ga-based PET-CT imaging on patient management in patients with a clinically suspected or histologically confirmed familial panNET. A retrospective electronic case note study was carried out in three ENETS Centres (Aintree/Royal Liverpool, Christie Hospital, Manchester and King’s College Hospital, London). Patients who had undergone a 68Ga based PET-CT scan for a panNET were identified using a prospectively populated list.
Results: We collected data for 52 patients (25 male, 27 female) with mean (SD) age of 50 (17) years; MEN type 1 was the predominant syndrome in 87% (n=45). 94% (n=48) were still alive and 6% (n=3) dead (1 missing). 42% (n=21) were non-functional tumours versus 58% (n=29) with functional tumours. A confirmed histological diagnosis (from biopsy/surgical resection) was available in 86% of patients (n=44) with imaging in the remainder. Tumours were in the head/neck, body, tail or were multi-focal in 38, 6, 28 and 28% of cases. Of those with histological grade available (n=32): 53% were Grade 1 tumours (n=17), 44% (n=14) were Grade 2 tand 3% (1) were Grade 3. 68% (n=34) were localised, 18% (n=9) were locally advanced and 14% (n=7) were metastatic. The indications for Ga68 PET-CT scans were diagnosis/staging 50% (n=26), post-operative assessment/clinical surveillance 46% (n=24) and consideration for peptide receptor radionuclide therapy (PRRT) 4% (n=2). In 75% of cases (n=39) tracer avid uptake was seen with no uptake in 25% (n=13). In 48% of cases the scan confirmed information gained from other imaging modalities but in 33% of cases it identified new sites of disease and in 4% ruled out suspected disease with previous imaging. Overall, Ga68 based PET-CT imaging led to change in management in 40% (n=21) of cases.
Conclusion: 68Ga-based imaging in patients with familial panNETs provides supplementary clinical information that guides diagnosis, staging, and most appropriate treatment.
Volume 60
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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