Neuroendocrine Tumors Clinical Trial
Official title:
Applying PET/MR in Neuroendocrine Tumors - Imaging Dynamic Processes in Both Modalities
Neuroendocrine tumors (NET's) are characterized, among other features, by presence of high
concentration of somatostatin receptors. In recent years, for purposes of Positron Emission
Tomography (PET) imaging, somatostatin receptor ligands have been labelled with the positron
emitting radioisotope 68Ga to form molecules that bind to these somatostatin receptors that
are present in high concentration in NET's and in low concentrations, if at all, in normal
tissues. In the last 10-15 years, radioactively labelled versions of these molecules have
been used for both diagnostic and therapeutic purposes in the management of patients with
NET's.
The main goal of this study is to assess the feasibility of performing dynamic 68Ga-DOTATATE
PET in the PET/MRI system and analyzing the effect of diffusion and perfusion over Ki values.
Working hypotheses
1. The PET/MR system will provide dynamic PET images of at least comparable quality
compared to PET/CT. Dynamic PET/MR will be feasible, with the 45 minute dynamic PET
acquisition occurring during the MR sequences, eliminating the need for the patient to
undergo two separate lengthy studies.
2. Diffusion and perfusion parameters extracted from MRI sequences will provide information
that improves the process of Ki evaluation.
3. The use of advanced statistics methodologies, such as those used in radiomics, to
correlate Ki data with diffusion and perfusion data will provide a quantification tool
that will improve staging, prediction and monitoring after treatment.
4. Parametric Patlak Ki images calculated from the dynamic series of PET images will show
better contrast between tumors and normal tissue, as compared to contrast in the
conventional static images obtained from the last time frame of the dynamic image
series. Tumors identified on the static PET image will be visualized at least as well on
Patlak Ki images, and possibly additional tumor foci may be identified. MRI should
assist in confirming and interpreting such findings.
Research plan Population: 50 patients with NETs that have evidence of at least one abdominal
lesion with diameter greater than 2cm. All patients will be aged 18 years or older of both
sexes.
Inclusion criteria: Patients with confirmed NET. Exclusion criteria: Patients younger than 18
years; pregnancy; other known active malignancy; contraindication to MRI tests or intravenous
contrast agents.
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