64Cu-DOTATATE somatostatin receptor imaging in neuroendocrine tumors: experience from 500 patients at Copenhagen ENETS Center of Excellence

Research output: Contribution to journalConference abstract in journalResearch

Background: In 2012 we introduced the somatostatin receptor imaging ligand 64Cu-DOTATATE. A potential benefit compared to SPECT tracers and 68Ga-labeled PET tracers included a better spatial image resolution. In addition, when compared to 68Ga-labeled tracers, the longer half-life of 64Cu (13h) compared to 68Ga (1h) could potentially make logistics easier, in particular in high-throughput centers. Here we present our experience having scanned more than 500 neuroendocrine tumor patients.

Methods: Description of performance and practical workflow based on the first 500 patients. Data summarized from both results obtained as part of our routine as well as from the clinical protocols for evaluation of diagnostic performance we have performed until now.

Results: The PET tracer 64Cu-DOTATATE is produced in batches for up to ten patient doses. These batches are released in the morning and the product has an approved shelf life of 24h. Accordingly, for practical purposes the patients may be scanned during the day and evening on the day of tracer production. Due to the long half-life, patients showing up late are no longer a major concern with regard to PET tracer use. Compared to 68Ga-labeled tracers, which we used previously and that typically are produced for 1-2 patients at a time, we have freed up radiochemist time at our department. Imaging is typically performed 1h after injection of approximately 200 MBq of 64Cu-DOTATATE but based on our first-in-human study, we have documented that image acquisition may be performed any time between 1 and 3h post injection. With regard to diagnostic performance, we have undertaken two head-to-head comparison studies with 111In-DTPA-octreotide and 68Ga-DOTATOC, respectively. On a lesion basis, 64Cu-DOTATATE was superior to both 111In-DTPA-octreotide and 68Ga-DOTATOC . Based on the first 112 patients, the sensitivity and specificity when using a composite standard of truth (CT only, follow up on imaging/biopsy) were 97% (CI: 91-99%) and 100% (CI: 96-100%), respectively. No major side-effects have been observed in the first 500 patients at our Center.

Conclusions: 64Cu-DOTATATE is a sensitive and convenient somatostatin receptor imaging tracer for routine use in a NET center.
Original languageEnglish
Article number504
JournalThe Journal of Nuclear Medicine
Issue numberS1
Number of pages1
Publication statusPublished - 2019

ID: 259108521