Evaluation of 18F-AlF-NOTA-octreotide for imaging neuroendocrine neoplasms: comparison with 68Ga-DOTATATE PET/CT

Abstract Objective To evaluate the diagnostic efficacy of 18 F-AlF-NOTA-octreotide ( 18 F-OC) PET/CT compared with that of 68 Ga-DOTATATE PET/CT. Materials and methods Twenty patients (mean age: 52.65 years, range: 24–70 years) with biopsy-proven neuroendocrine neoplasms (NENs) were enrolled in this prospective study. We compared the biodistribution profiles in normal organs based on the maximum standard uptake value (SUV max ) and mean standard uptake value (SUV mean ), and uptake in NEN lesions by measuring the SUV max on 18 F-OC and 68 Ga-DOTATATE PET/CT images. The tumor-to-liver ratio (TLR) and tumor-to-spleen ratio were calculated by dividing the SUV max of different tumor lesions by the SUV mean of the liver and spleen, respectively. The Wilcoxon signed-rank test was used to compare nonparametric data. Data were expressed as the median (interquartile range). Results In most organs, there were no significant differences in the biodistribution of 68 Ga-DOTATATE and 18 F-OC. 18 F-OC had significantly lower uptake in the salivary glands and liver than 68 Ga-DOTATATE. 18 F-OC detected more lesions than 68 Ga-DOTATATE. The uptake of 18 F-OC in the tumors was higher in most patients, but the difference was not statistically significant relative to that of 68 Ga-DOTATATE. However, the TLRs of 18 F-OC were higher in most patients, including for lesions in the liver ( p = 0.02) and lymph nodes ( p = 0.02). Conclusion Relative to 68 Ga-DOTATATE, 18 F-OC possesses favorable characteristics with similar image quality and satisfactory NEN lesion detection rates, especially in the liver due to its low background uptake. 18 F-OC therefore offers a promising clinical alternative for 68 Ga-DOTATATE.