Purpose: To evaluate the added benefit and accuracy of [68Ga]Ga-DOTA-TATE PET/CT scans in detecting pancreatic neuroendocrine tumours, compared to conventional cross-sectional imaging with CT or MRI scans, in patients with multiple endocrine neoplasia type 1 (MEN1)
Methods: A retrospective analysis was performed comparing the initial [68Ga]Ga-DOTA-TATE PET/CT to the respective contemporary CT or MRI imaging in patients with MEN1 under the care of a tertiary endocrine centre. Imaging and electronic patient records were analysed to identify treatment plans and the records of multidisciplinary team discussions.
Results: In total, 85% (n=39/46) of patients with MEN1 had a [68Ga]Ga-DOTA-TATE PET/CT study in the electronic patient record; 23 of these also had contemporaneous contrast enhanced CT scans, while 18 had MRI scans. [68Ga]Ga-DOTA-TATE PET/CT detected a total of 47 pancreatic lesions compared to 25 on CT, while [68Ga]Ga-DOTA-TATE PET/CT detected 36 lesions compared to 24 on MRI. In 18% of patients (n=7/39), pancreatic lesions were detected on [68Ga]Ga-DOTA-TATE PET/CT which were not seen on MRI or CT, while 33% (n=13/39) had extra-pancreatic lesions detected on [68Ga]Ga-DOTA-TATE PET/CT that were not seen on MRI or CT. As a result of findings on [68Ga]Ga-DOTA-TATE PET/CT scanning, a change of management was indicated in 82% (n=32/39) of patients. Of these, 33% (n=13/39) were referred for further investigations, 23% (n=9/39) were started on somatostatin analogues, while 15% (n=6/39) were recommended surgery.
Conclusion: In patients with MEN1, [68Ga]Ga-DOTA-TATE PET/CT was shown to detect a greater number of pancreatic and metastatic lesions compared to conventional cross-sectional CT or MRI imaging. Management plans were changed in most patients following their initial [68Ga]Ga-DOTA-TATE PET/CT. Therefore, we suggest that such radionuclide scanning should be an integral part of the investigation of patients with MEN1.