![]() ![]() ![]() This AUC document focuses on 68Ga-DOTATATE and 68Ga-DOTATOC, which are collectively referred to as SSTR PET. These agents have several benefits over 111In-pentetreotide, including improved detection sensitivity, improved patient convenience due to the 2-h length of the study, decreased radiation dose, decreased biliary excretion due to earlier imaging after radiotracer administration, and the ability to quantify uptake. A New Drug Application for 68Ga-DOTATOC is being developed by the University of Iowa. 68Ga-DOTATATE (NETSPOT Advanced Accelerator Applications) is currently approved by the Food and Drug Administration. Newer imaging agents targeting SSTR labeled with 68Ga have subsequently been developed, namely, DOTATATE and DOTATOC ( 7). Representatives from the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the American College of Radiology (ACR), the American Society of Clinical Oncology (ASCO), the North American Neuroendocrine Tumor Society (NANETS), the European Association of Nuclear Medicine (EANM), the Endocrine Society, the Society of Surgical Oncology, the National Comprehensive Cancer Network (NCCN), the American College of Physicians (ACP), the American Gastroenterological Association (AGA), and the World Conference on Interventional Oncology (WCIO) assembled under the auspices of an autonomous workgroup to develop the following AUC. Of the 12 clinical scenarios evaluated, 9 were graded as appropriate: initial staging after the histologic diagnosis of NET, evaluation of an unknown primary, evaluation of a mass suggestive of NET not amenable to endoscopic or percutaneous biopsy, staging of NET before planned surgery, monitoring of NET seen predominantly on SSTR PET, evaluation of patients with biochemical evidence and symptoms of a NET, evaluation of patients with biochemical evidence of a NET without evidence on CI or a prior histologic diagnosis, restaging at time of clinical or laboratory progression without progression on CI, and new indeterminate lesion on CI with unclear progression. The indications were evaluated in well-differentiated NETs. These appropriate use criteria (AUC) are intended to aid referring medical practitioners in the appropriate use of SSTR PET for imaging of patients with NETs. SSTR PET should replace 111In-pentetreotide scintigraphy (OctreoScan Mallinckrodt) in all indications in which the latter is currently being used. Somatostatin receptor (SSTR) PET has demonstrated a significant improvement over conventional imaging (CI) in patients with neuroendocrine tumors (NETs).
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