68Ga-DOTATATE Compared with 111In-DTPA-Octreotide and Conventional Imaging for Pulmonary and Gastroenteropancreatic Neuroendocrine Tumors: A Systematic Review and Meta-Analysis
Neuroendocrine tumors (NETs) are uncommon but with increasing incidence and prevalence. Current reports suggest (68)Ga-DOTATATE PET/CT imaging improves diagnosis and staging of NETs compared to (111)In-DTPA-octreotide (octreotide) and conventional imaging. We performed a systematic review of (68)Ga-DOTATATE for safety and efficacy compared to octreotide and conventional imaging to determine if available evidence supports US FDA approval.
Medline, EMBASE, Web of Science and Cochran Reviews electronic databases were searched from January 1999, through September 2014, following PRISMA guidelines. Results were restricted to human studies comparing diagnostic accuracy of (68)Ga-DOTATATE to octreotide and conventional imaging for pulmonary or gastroenteropancreatic (GEP) NET, and for human studies reporting safety/toxicity for (68)Ga-DOTATATE with ≥10 subjects. Direct communication with corresponding authors provided missing information including toxicity. Abstracts meeting eligibility criteria were collected by a research librarian and reviewed independently by two reviewers.
Database and bibliography searches yielded 2380 articles, of which 36 were eligible. One unpublished comparative study was conducted prospectively. Three studies compared the two radiopharmaceuticals in the same patient and found (68)Ga-DOTATATE to be more sensitive than octreotide. Eight studies compared (68)Ga-DOTATATE to conventional imaging. (68)Ga-DOTATATE estimated sensitivity 90.3% (95%CI: 80.8%, 95.8%) and 90.6% (95%CI: 79.0%, 96.1%) specificity were high. Eleven studies were retained for safety reporting. Report of harm possibly related to (68)Ga-DOTATATE was rare (4 of 681), and no study reported major toxicity or safety issues.
No direct comparison of octreotide and (68)Ga-DOTATATE for diagnosis and staging in an unbiased population of NETs has been published. Available information in the peer-reviewed literature regarding diagnostic efficacy and safety supports the use of (68)Ga-DOTATATE for imaging of NETs where it is available.
This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 October 2021.
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