Endocrine Abstracts

Background: Neuroendocrine tumor (NET) metastases to the heart are found in 1-4% of NET patients and have been reported primarily in the form of individual cases. We investigated the incidence, clinical characteristics, imaging features, and outcomes of NET patients with cardiac metastases on 68Ga-DOTATATE PET/CT.Methods: The medical records of 406 neuroendocrine tumor patients who underwent 68Ga-DOTATATE PET/CT for their clinical c...

Background: Advanced neuroendocrine tumors (NETs) are associated with poor prognoses. A 4-dose regimen of lutetium Lu 177 (177Lu)-DOTATATE has been shown to improve progression-free survival (PFS) and overall survival (OS) in patients with advanced NETs. This is the first United States (US) study to evaluate the effectiveness and safety of additional doses in patients with progressive NETs.Methods: This was a retrospective chart review of 31 a...

Background: Somatostatin receptor (SSTR) PET imaging is utilized with increasing frequency in the clinical management of neuroendocrine tumors. Incidental PET-avid CNS lesions are commonly noted and presumed to be meningiomas. However, SSTR PET lacks specificity for meningioma identification. This study aims to clarify the role of SSTR-based imaging for classification of incidental CNS lesionsMethods: Patients who had undergone both Ga-68-DOTATATE PET an...

Background: Capecitabine-Temozolomide (CapTem) is an effective oral chemotherapy regimen for NETs. Both drugs are radiosensitizers. A feasibility study of integrated CapTem and Y90 transarterial radioembolization (TARE) in patients with grade 2 neuroendocrine tumor (NET) liver metastases reported encouraging objective response rate (ORR) and progression-free survival (PFS). This study expands that report to a larger cohort with long-term oncologic follow-up.<p class="abste...

Background: Capecitabine and temozolomide (CapTem) are classic radiosensitizers used in combination with radiation therapy for many cancers. A feasibility study of integrated CapTem and Y90 transarterial radioembolization (TARE) for neuroendocrine tumors (NETs) suggests synergy with PFS of 31 months exceeding historical controls. The impact of duration of chemotherapy after TARE on PFS is not known.Methods: 36 subjects with liver-domianant grade 2 metast...

Background: We observed patients with well-differentiated NETs who received PRRT with 177Lu-dotatate and later developed rapid disease progression with biopsy-proven histologic transformation to NECs, an outcome that has not been previously described. In this series, we characterize the clinicopathologic features and outcomes of patients whose tumors underwent poorly-differentiated transformation.Methods: After obtaining IRB approval, we condu...

Background: High-specific activity iodine-131 metaiodobenzylguanidine (HSA I-131 MIBG; AZEDRA®) is the only FDA approved systemic treatment for locally advanced or metastatic pheochromocytoma or paraganglioma (PPGL). We have previously described pivotal study efficacy data that served as the basis for HSA I-131 MIBG approval demonstrating improvements in blood pressure control, objective tumor responses, and biomarker responses. Here we provide the results from a European...

Background: Tumors of neuroendocrine origin are a rare, heterogenous group of neoplasms. Neuroendocrine neoplasms (NENs) are categorized by site of origin, differentiation status, and by grade (Ki-67 expression and/or mitotic rate), with significant prognostic variability accordingly. These tumors frequently metastasize to bone, with reported incidence between 6-12% by older SSTR imaging. Our study evaluates patients with well-differentiated tumors of neuroendocrine origin to ...

Background: Despite the superiority of 68Ga-DOTATATE PET/CT in the detection of neuroendocrine tumors, the clinical impact of using this imaging modality in surgical and medical oncology practices in the United States is not well established. Here we evaluate the impact of 68Ga-DOTATATE PET/CT imaging in the diagnosis and management of patients with GI and pancreatic NETs at the University of Rochester Medical Center.Methods: Single...

Background: Somatostatin receptor (SSTR) expression in metastatic lung neuroendocrine (carcinoid) tumors has not been well-characterized using modern positron emission tomography (PET) imaging. Understanding degree and uniformity of SSTR expression is important to establish the role of SSTR targeted treatments, including peptide receptor radiotherapy (PRRT), in lung NETs.Methods: Retrospective review of medical records and imaging studies of patients wit...

Background: Since the FDA-approval of Lu177-DOTATATE and I131-MIBG radiopharmaceutical therapies in 2018, there is emerging real-world experience with their use. Only a few institutions in the US have both therapies available. Here, we describe our experience with these agents for patients with pheochromocytoma and paraganglioma (PPGL).Methods: This is a retrospective evaluation of all patients with progressive, metastatic, PPGL referred for radiopharmac...

Background: We aimed to evaluate the added information provided by 68Ga-DOTATATE PET after two cycles of peptide receptor radionuclide therapy (PRRT) in patients with somatostatin receptor (SSTR)-expressing neuroendocrine tumors (NET).Methods: In this retrospective study, 105 patients (54 women and 51 men, 62.5&pm;10.5-year-old) with progressive NET treated with at least two cycles of 177Lu-DOTATATE were included. All patients had <...

Background: Since their FDA-approval in 2018, both Lu177-DOTATATE and I131-MIBG radiopharmaceutical therapies are available at our institution for the treatment of pheochromocytoma and paraganglioma (PPGL). Tumor uptake of the radiopharmaceutical on pre-therapy imaging is a requirement for treatment. Here, we describe our experience with pre-therapy imaging, and how it relates to the tumor genotype and the therapeutic choice.Methods: This is a retrospect...

Background: To evaluate and compare the diagnostic performance of 68Ga-DOTATATE PET/CT to 18F-FDG PET/CT, CT of neck, chest, abdomen and pelvis (CT), and MRI of cervical, thoracic, and lumbar spine (MRI spine), for the detection of spinal bone metastases in metastatic pheochromocytoma and/or paraganglioma (PPGL).Methods: Between 2014 and 2019, 41 consecutive metastatic PPGL patients (19 females; mean age, 43 years) underwent 68...

Background: Pheochromocytoma (PHEO) is a rare neuroendocrine tumor arising from chromaffin cells of adrenal gland that can cause life-threatening complications due to overproduction of catecholamines. Per EANM/SNMMI 2019 guidelines for radionuclide imaging of PHEO and paraganglioma, 18F-fluoro-L-dihydroxyphenylalanine (18F-FDOPA) is recommended as a positron emission tomography (PET) radiotracer of choice followed by 68Ga-DOTA(0)-Tyr(3)-octreot...

Background: The purpose of this prospective study was to evaluate and compare the detection rates of 18F-L-dihydroxyphenylalanine (18F-FDOPA), 68Ga-DOTATATE, 18F-FDG, and 18F-fluorodopamine (18F-FDA) PET or positron emission tomography/computed tomography (PET/CT), computed tomography (CT), and magnetic resonance imaging (MRI) in the detection of VHL-related pheochromocytoma (PHEO).<p class="abstext...