Journal of nuclear medicine : official publication, Society of Nuclear Medicine
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Randomized Controlled Trial Clinical Trial
Comparison of 68Ga-DOTANOC and 68Ga-DOTATATE PET/CT within patients with gastroenteropancreatic neuroendocrine tumors.
Somatostatin receptor PET tracers such as [(68)Ga-DOTA,1-Nal(3)]-octreotide ((68)Ga-DOTANOC) and [(68)Ga-DOTA,Tyr(3)]-octreotate ((68)Ga-DOTATATE) have shown promising results in patients with neuroendocrine tumors, with a higher lesion detection rate than is achieved with (18)F-fluorodihydroxyphenyl-l-alanine PET, somatostatin receptor SPECT, CT, or MR imaging. (68)Ga-DOTANOC has high affinity for somatostatin receptor subtypes 2, 3, and 5 (sst2,3,5). It has a wider receptor binding profile than (68)Ga-DOTATATE, which is sst2-selective. The wider receptor binding profile might be advantageous for imaging because neuroendocrine tumors express different subtypes of somatostatin receptors. The goal of this study was to prospectively compare (68)Ga-DOTANOC and (68)Ga-DOTATATE PET/CT in the same patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and to evaluate the clinical impact of (68)Ga-DOTANOC PET/CT. ⋯ The sst2,3,5-specific radiotracer (68)Ga-DOTANOC detected significantly more lesions than the sst2-specific radiotracer (68)Ga-DOTATATE in our patients with GEP-NETs. The clinical relevance of this finding has to be proven in larger studies.
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Hybrid PET/MR combines the exceptional molecular sensitivity of PET with the high resolution and versatility of MR imaging. Simultaneous data acquisition additionally promises the use of MR to enhance the quality of PET images, for example, by respiratory motion correction. This advantage is especially relevant in thoracic and abdominal areas to improve the visibility of small lesions with low radiotracer uptake and to enhance uptake quantification. In this work, the applicability and performance of an MR-based method of respiratory motion correction for PET tumor imaging was evaluated in phantom and patient studies. ⋯ The proposed method for MR-based respiratory motion correction of PET data proved feasible and effective. The short examination time and convenience (no additional equipment required) of the method allow for easy integration into clinical routine imaging. Performance compared with gating procedures can be further improved using list-mode-based motion correction.
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PET/CT and other combined scanners have in the past decade rapidly emerged as important research tools and are proving to be invaluable for improved diagnostics in routine nuclear medicine. The design of hybrid PET/MR scanners presented a formidable technical challenge, and only recently were these instruments introduced to the market. ⋯ However, the additional value and potential clinical role that these new systems might bring to the cardiac field have yet to be documented. This review presents a comparative summary of the existing applications for PET and MR in the field of cardiology and suggests potential cardiac applications exploiting unique properties of the newly introduced combined instrumentation.