The Potential Prognostic Value of Dual-Imaging PET Parameters Based on F-FDG and F-OC for Neuroendocrine Neoplasms.

Background: To identify parameters based on dual-imaging F-AlF-NOTA-octreotide (F-OC) and 18-fluorodeoxyglucose (F-FDG) positron emission tomography (PET) for predicting the prognosis of neuroendocrine neoplasms (NENs).

Materials And Methods: Sixty-six patients (age: mean ± standard deviation (SD): 51.8 ± 11.8 years) who underwent both F-OC and F-FDG PET/CT imaging were enrolled in our retrospective study. The following PET parameters were measured: the maximum standardized uptake value (SUV) and the volumetric parameters-F-OC SSR-derived tumor volume (TV) and somatostatin receptor expression (SRE, TV multiplied by the mean standardized uptake value (SUV)) and the F-FDG-derived multiple tumor volume (MTV) and tumor lesion glycolysis (TLG). The NETPET grade based on dual-imaging PET images was assessed. Progression-free survival (PFS) was set as an endpoint. Univariate and multivariate survival analyses were performed for PET parameters and clinical tumor data.

Results: In the univariate survival analyses of clinical information, PFS was significantly associated with age (>45.5 vs ≤45.5, years, < 0.034) and the presence of bone metastases ( = 0.04). Higher values for the F-FDG and F-OC volumetric parameters and the NETPET grade were adverse factors for PFS according to the dual-imaging PET parameters. In the multivariate survival analysis, the NETPET grade and SRE were predictors of PFS in NEN patients.

Conclusion: The NETPET grade is a potential noninvasive prognostic biomarker for NENs.