Substitution of 68-Ga-DOTA-peptide PET/CT scanning in lieu of Octreotide for patients undergoing somatostatin receptor diagnostic imaging under MBS item 61369

Morona, JK, Mittal, R
Record ID 32018000663
Original Title: Application 1479r
Authors' results and conclusions: The 68-Gallium-1,4,7,10-tetra-azacyclododecane-1,4,7,10-tetraacetic acid-peptide (68-Ga-DOTA-peptide) positron emission tomography/computed tomography (PET/CT) is more sensitive, with an improved negative predictive value (NPV) indicating that there are fewer false negative patients compared with 111-Indium (In)-octreotide single-photon emission computed tomography/computed tomography (SPECT/CT). Additionally, increased clarity of the 68-Ga-DOTA-peptide PET images in comparison with 111-In-octreotide SPECT enabled a more accurate detection of the extent of disease and localisation of the primary tumour. The increased accuracy and clarity resulted in a change in management in approximately 40% of all patients, irrespective of whether or not the patients had had prior 111-In-octreotide SPECT/CT imaging. These changes in management resulted in more patients being directed towards surgery, somatostatin analogue (SSA) therapy or peptide receptor radionuclide therapy (PRRT) rather than chemotherapy. Treatment of gastroenteropancreatic neuroendocrine tumours (GEP NETs) with surgery, SSA therapy or PRRT appear to be more effective than no treatment or chemotherapy and are relatively safe. 68-Ga-DOTA-peptide PET/CT is also safer with lower radiation exposure and quicker (2 hours versus 2 days) than 111-In-octreotide SPECT/CT. When taken together, these results suggest that replacement of 111-In-octreotide SPECT/CT with 68-Ga-DOTA-peptide PET/CT is likely to lead to better patient outcomes in up to 30% of patients.
Project Status: Completed
Year Published: 2017
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Australia
MeSH Terms
  • Positron-Emission Tomography
  • Single Photon Emission Computed Tomography Computed Tomography
  • Gallium Radioisotopes
  • Octreotide
  • Receptors, Somatostatin
  • Carcinoma, Neuroendocrine
  • Indium Radioisotopes
Organisation Name: Adelaide Health Technology Assessment
Contact Address: School of Public Health, Mail Drop 545, University of Adelaide, Adelaide SA 5005, AUSTRALIA, Tel: +61 8 8313 4617
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Copyright: Adelaide Health Technology Assessment (AHTA)
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