Optimizing Somatostatin Receptor Imaging in Patients With Neuroendocrine Tumors: The Impact of 99mTc-HYNICTOC SPECT/SPECT/CT Versus 68Ga-DOTATATE PET/CT Upon Clinical Management

Aim: The presence of somatostatin receptors in neuroendocrine tumors allows visualization with radiolabeled somatostatin analogs in vivo. The aim of this prospective study was to compare somatostatin receptor imaging using 99mTc-HYNICTOC with 68Ga-DOTATATE (DOTA-DPhe1,Tyr3-octreotate) with respect to sensitivity, specificity, and impact upon clinical decision making. Methods: Sixty-eight patients (30 men, 38 women; aged 56.4 ± 13.5 years) with disseminated, histologically proven neuroendocrine tumor were enrolled. All patients with previous 99mTc-HYNICTOC (Tektrotyd; POLATOM, Otwock, Poland) underwent 68Ga-DOTATATE PET/CT. Both examinations were compared on a per-patient and per-lesion basis. Results: The sensitivity, specificity, positive and negative predictive values, and accuracy of 68Ga-DOTATATE and 99mTc-HYNICTOC were 100% versus 82%, 85% versus 69%, 97% versus 92%, 100% versus 47%, and 97% versus 79%, respectively. Concordant results were observed in 58 patients (49/68 positive on both 68Ga-DOTATATE and 99mTc-HYNICTOC and 9/68 negative in both examinations). Ten of 68 patients had 68Ga-DOTATATE–positive, 99mTc-HYNICTOC–negative studies. Two hundred eighteen lesions were detected using 99mTc-HYNICTOC, compared with 546 lesions using 68Ga-DOTATATE (P

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