Correlation of DOTATOC Uptake and Pathologic Grade in Neuroendocrine Tumors,
     
Chan, Hilary; Moseley, Christian; Zhang, Li; More
Pancreas. 48(7):948-952, August 2019.

Abstract
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Objectives
68 Gallium (Ga)–DOTATOC is a somatostatin analog used to detect neuroendocrine tumors (NETs). Ki-67 proliferation index (Ki-67 PI) has been established as a prognostic factor in NETs. We aimed to evaluate whether a correlation exists between Ki-67 PI and somatostatin receptor positron emission tomography (SSTR-PET) uptake.

Methods
We retrospectively reviewed 238 DOTATOC PET scans between 2014 and 2016. Patients were excluded if DOTATOC PET was performed more than 365 days from the date of biopsy. Maximum standardized uptake values (SUV max ) of SSTR-PET from biopsied lesions were measured and correlated with Ki-67 PI using the Pearson correlation coefficient.

Results
Among 110 lesions from 90 patients, DOTATOC PET had 92.7% sensitivity and 100% specificity (102 true positives, 8 false negatives) for detection of NETs. Among 63 lesions from 54 patients with Ki-67 PI available, there were 27 grade 1 lesions [median Ki-67 PI, 1.0%; interquartile range (IQR), 1.0–2.0], 30 grade 2 lesions (median, Ki-67 PI 7.5%; IQR, 5–10), and 6 grade 3 lesions (median Ki-67 PI, 30%; IQR, 26–34). There was a correlation between Ki-67 PI and SUV max ( r 2 = −0.3 , P = 0.018).

Conclusions
Our analysis demonstrates an inverse correlation between Ki-67 PI and SUV max in NETs. Somatostatin receptor–PET provides additional information that can help guide management of NETs.