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. Author manuscript; available in PMC: 2019 Sep 1.
Published in final edited form as: Expert Rev Anticancer Ther. 2018 Jul 17;18(9):837–860. doi: 10.1080/14737140.2018.1496822

Table 6:

Recent results (2013–2017) with 18F-FDG PET/CT : Sensitivity with panNETs only and all NETs (Part A); comparison with 111In-Penetreotide SPECT/CT (Part B); effect of grading on FDG positivity(Part C); prognostic value for tumor grade/differentiation or survival (Part D); and effect of FDG on treatment(Part E) or patient management (Part F)

A. Recent results 68Ga-DOTA-SSA PET/CT: Sensitivity, specificity with panNETs only and all NETs

  1. Sensitivity with panNETs only : 2017[(68%%)[23],(58%)[147],(60%)[282]; 2016[(65%)[296]; 2014[(73%)[285]

  2. Sensitivity with series containing various GI-NETs including panNETs: 2017[(67%)[23]; 2016[(49%)[297],(58%)[141]; 2015[(72%)[298]; 2014[(56%)[137],(37%)[24]

B. Recent results comparing sensitivity of 68Ga-DOTA-SSA PET/CT to 18F-FDG PET/CT

  1. Sensitivity with panNETs only : 2017(94% vs 60%)[282]; 2014[(98% vs 73%)[285];

  2. Sensitivity with series containing various GI-NETs including panNETs: 2014[(100% vs 56%)[137],(95% vs 37%)[24],(91% vs 42%%)[136]

  3. Specificity with series containing various GI-NETs including panNETs: 2014[(50% vs 100%)[136]

C. Recent results 18F-FDG PET/CT : Affect of tumor grade on positivity

  1. Sensitivity with panNETs only : G1 (28%) [296], (20%) [282], (45%) [285]; G2 (83%) [296], (33%) [285],(76%) [282]; G3 (75%) [121],(88%) [285]

  2. Sensitivity with series containing various GI-NETs including panNETs: G1 (17%) [24], (10%) [299]; G2 (43%) [24], (25%) [299],(86%) [298]; G3 (51%) [24],(65%) [299], (100%) [298];

D. 18F-FDG PET/CT correlating with prognosis: grade/differentiation/survival

  1. On univariate analysis in patients with panNETs, the metabolic tumor volume(MTV)(p=0.003) and total lesion glycolysis (TLG) (p=0.027) computed from18F-FDG PET/CT were significant predictors of OS[300]. MTV and TLG correlated with a higher Ki-67[142]

  2. 18F-FDG PET/CT positivity predicted progressive disease in NETs(sensitivity-91%, specificity-86%)[23]; and/or postoperative DFS(p=0.0463)[148].

  3. 18F-FDG PET/CT positivity or SUVmax correlated with increased tumor grade (p=0.01)[280], p=0.018[24,143,148,282,285,301]; increased Ki-67[296]; increased tumor size (p=0.01)[296], [282], metastatic lymph nodes[282]

  4. 18F-FDG PET/CT positivity had a sensitivity of 100% and specificity of 62% in differentiating G1/G2 form G3 panNETs[148]

  5. 18F-FDG PET/CT positivity or SUVmax correlated with shorter PFS[137,297,301], overall survival[297,299,301]

E. 18F-FDG PET/CT correlating with treatment responses

  1. FDG positivity correlated with treatment refractoriness with PRRT with 177Lu DOTATATE[146]; a shorter PFS after PRRT (21 vs 69 mos)[147]

F. 18F-FDG PET/CT results altered patient management

  1. The 18F-FDG PET/CT result changed management in 22% of NET patients, whereas the 68Ga-DOTA-SSA PET/CT result changed management in 50% of patients in one study[143]