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Optimal follow-up with somatostatin receptor PET/CT imaging in patients with small intestinal neuroendocrine tumours

Ohlsson, Håkan LU orcid ; Spaak, Elisabeth ; Gålne, Anni LU orcid ; Sundlöv, Anna LU orcid and Almquist, Martin LU (2024) In Journal of Neuroendocrinology
Abstract

Somatostatin receptor positron emission tomography with computerised tomography imaging (SRI) has a high sensitivity for the detection of small intestinal neuroendocrine tumors (siNET), which makes it ideal for follow-up. The aim of the present study was to investigate whether follow-up with SRI in patients with siNET led to any change in the treatment of the patient and if patient and/or tumour factors were associated with such change. Adults with siNET who had undergone at least two SRI scans between 2013 and 2021 were identified. Data on age, sex, comorbidities, tumour stage, grade, and most recent levels of serum Chromogranin A (CgA) and 24-h urine 5-hydroxyindoleacetic acid (5-HIAA) before each SRI scan were obtained. The major... (More)

Somatostatin receptor positron emission tomography with computerised tomography imaging (SRI) has a high sensitivity for the detection of small intestinal neuroendocrine tumors (siNET), which makes it ideal for follow-up. The aim of the present study was to investigate whether follow-up with SRI in patients with siNET led to any change in the treatment of the patient and if patient and/or tumour factors were associated with such change. Adults with siNET who had undergone at least two SRI scans between 2013 and 2021 were identified. Data on age, sex, comorbidities, tumour stage, grade, and most recent levels of serum Chromogranin A (CgA) and 24-h urine 5-hydroxyindoleacetic acid (5-HIAA) before each SRI scan were obtained. The major change was defined as new treatment previously not received or discontinuation of ongoing treatment. Univariate and multivariate mixed models logistic regression on variables with a presumed biological relationship with major change and with backwards stepwise exclusion of variables with p > .1 was performed. A total of 164 patients with siNET diagnosis had undergone 570 SRI scans. The median follow-up was 3.1 years. Only 82 of 570, 14%, of SRI scans led to a major change in treatment. Female sex, age below 75 years, elevated or missing CgA, elevated or missing urine 5-HIAA, progress on last SRI scan and distant extrahepatic disease were all independently associated with increased odds ratios for major change after follow-up with SRI. A small proportion of SRI scans (14%) led to a major change in treatment. Six independent risk factors with increased odds of major change, all available before each SRI scan, were identified. While validation of these risk factors is needed in a separate cohort, these findings could help clinicians individualise follow-up for siNET patients in the future.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
chromogranin A, follow-up, neuroendocrine tumours, positron emission tomography, small intestine
in
Journal of Neuroendocrinology
article number
e13396
pages
9 pages
publisher
Wiley-Blackwell
external identifiers
  • pmid:38679928
  • scopus:85191843615
ISSN
0953-8194
DOI
10.1111/jne.13396
language
English
LU publication?
yes
id
4e564929-8264-4e5b-b88c-d440251c3fb9
date added to LUP
2024-05-06 10:26:39
date last changed
2024-06-04 07:06:52
@article{4e564929-8264-4e5b-b88c-d440251c3fb9,
  abstract     = {{<p>Somatostatin receptor positron emission tomography with computerised tomography imaging (SRI) has a high sensitivity for the detection of small intestinal neuroendocrine tumors (siNET), which makes it ideal for follow-up. The aim of the present study was to investigate whether follow-up with SRI in patients with siNET led to any change in the treatment of the patient and if patient and/or tumour factors were associated with such change. Adults with siNET who had undergone at least two SRI scans between 2013 and 2021 were identified. Data on age, sex, comorbidities, tumour stage, grade, and most recent levels of serum Chromogranin A (CgA) and 24-h urine 5-hydroxyindoleacetic acid (5-HIAA) before each SRI scan were obtained. The major change was defined as new treatment previously not received or discontinuation of ongoing treatment. Univariate and multivariate mixed models logistic regression on variables with a presumed biological relationship with major change and with backwards stepwise exclusion of variables with p &gt; .1 was performed. A total of 164 patients with siNET diagnosis had undergone 570 SRI scans. The median follow-up was 3.1 years. Only 82 of 570, 14%, of SRI scans led to a major change in treatment. Female sex, age below 75 years, elevated or missing CgA, elevated or missing urine 5-HIAA, progress on last SRI scan and distant extrahepatic disease were all independently associated with increased odds ratios for major change after follow-up with SRI. A small proportion of SRI scans (14%) led to a major change in treatment. Six independent risk factors with increased odds of major change, all available before each SRI scan, were identified. While validation of these risk factors is needed in a separate cohort, these findings could help clinicians individualise follow-up for siNET patients in the future.</p>}},
  author       = {{Ohlsson, Håkan and Spaak, Elisabeth and Gålne, Anni and Sundlöv, Anna and Almquist, Martin}},
  issn         = {{0953-8194}},
  keywords     = {{chromogranin A; follow-up; neuroendocrine tumours; positron emission tomography; small intestine}},
  language     = {{eng}},
  month        = {{04}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of Neuroendocrinology}},
  title        = {{Optimal follow-up with somatostatin receptor PET/CT imaging in patients with small intestinal neuroendocrine tumours}},
  url          = {{http://dx.doi.org/10.1111/jne.13396}},
  doi          = {{10.1111/jne.13396}},
  year         = {{2024}},
}