PET offers more precise screening method to select candidates for radionuclide therapy

A new study published in The Journal of Nuclear Medicine evaluated the role of 68Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) in selecting neuroendocrine tumor patients who may benefit from peptide receptor radionuclide therapy (PRRT). Although historically guided by a Krenning score based on 111In-pentetreotide scintigraphy, researchers found that Krenning scores based on PET/CT imaging were significantly higher and could more accurately detect patients eligible for PRRT. This is particularly relevant for patients with lesions of less than two centimeters, as the study showed that Krenning scores for these small-volume tumors were markedly higher when informed by PET/CT compared to 111In-pentetreotide scintigraphy and could qualify the patients for PRRT when they would otherwise have been ineligible.

"In the past, physicians relied on 111In-pentetreotide imaging with planar scintigraphy and single photon emission computed tomography (SPECT) to determine whether or not a patient is eligible to receive 177Lu-DOTATATE PRRT," said Thomas A. Hope, MD, associate professor of radiology at the University of California, San Francisco. "However, limited literature is available on the accuracy of PET/CT in determining 177Lu-DOTATATE PRRT eligibility. Our study aimed to compare the Krenning scores derived from the various imaging modalities and assess the impact on treatment decision-making."

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