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Visualization of Somatostatin Receptors in Prostate Cancer and its Bone Metastases with Ga-68–DOTATOC PET/CT

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Abstract

Purpose

To assess DOTATOC-affine somatostatin receptor expression in advanced prostate cancer and its bone metastases with regard to DOTATOC-mediated receptor therapies, using a Ga-68–DOTATOC PET/CT.

Procedures

Twenty consecutive patients with advanced prostate cancer underwent bone scintigraphy, followed by Ga-68–DOTATOC PET/CT within 3 weeks. Through side-by-side comparison with bone scintigraphy, the number of visible bone metastases on PET was determined. In addition, in cases of visible metastases, the maximum standard uptake value (SUVmax) of Ga-68–DOTATOC was measured in the metastases and in normal bone. In patients who did not undergo a prostatectomy (n = 12), the SUVmax was additionally measured in the prostate and in adjacent tissue. For focal lesions, the difference in SUVmax (ΔSUVmax) between the metastases and normal bone was calculated. For patients still having their prostate, a ΔSUVmax between the prostate and its adjacent tissue was calculated.

Results

Sixty four of 216 metastases (30%) were visible in 13 patients with focal metastases. Of six patients with diffuse metastases (superscan), one showed diffuse metastases, three showed a total of ten focal metastases, and two showed no correlate on PET. One patient with a neuroendocrine prostate cancer showed no correlate on PET. The maximum ΔSUVmax between metastases and normal bone was 4.9 (mean = 1.6 ± 0.9) and between the prostate and adjacent tissue 5.9 (mean = 2.8 ± 1.6).

Conclusions

In prostate cancer and its bone metastases, DOTATOC-affine somatostatin receptors (subtype 2 and 5) can be visualized with Ga-68–DOTATOC PET/CT. But their expression is so weak that other conjugates should be tested for receptor-mediated therapies which are better at addressing the prostate cancer-specific somatostatin receptor subtypes 1 and 4—or even other receptors.

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Abbreviations

DOTATOC:

1,4,7,10-Tetraazacyclododecane-4,7,10-tricarboxy-methyl-1-yl-acety-d-Phe1-Try3-octreotide

PET/CT:

Positron emission tomography/computed tomography

SUVmax :

Maximum standard uptake value

SSTR:

Somatostatin receptor

RRT:

Receptor radiation therapy

CgA:

Chromogranin A

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Authors and Affiliations

  1. Clinic and Policlinic of Nuclear Medicine, University Hospital Dresden, Dresden, Germany

    Wolfgang Luboldt, Klaus Zöphel, Gerd Wunderlich, Andrij Abramyuk & Joerg Kotzerke

  2. Clinic and Policlinic of Urology, University Hospital Essen, Essen, Germany

    Hans-Joachim Luboldt

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  1. Wolfgang Luboldt
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Luboldt, W., Zöphel, K., Wunderlich, G. et al. Visualization of Somatostatin Receptors in Prostate Cancer and its Bone Metastases with Ga-68–DOTATOC PET/CT. Mol Imaging Biol 12, 78–84 (2010). https://doi.org/10.1007/s11307-009-0230-3

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