<sup>68</sup>Ga-DOTA-peptide: A novel molecular biomarker for nasopharyngeal carcinoma

Lih Kin Khor, Hoi Yin Loi, Arvind Kumar Sinha, Kian Ti Tong, Boon Cher Goh, Kwok Seng Loh, Suat Jin Lu

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Increased somatostatin receptor (SSTR) expression in patients with undifferentiated nasopharyngeal carcinoma (NPC) has been demonstrated with receptor autoradiography, <sup>111</sup>In-Octreotide scintigraphy, and <sup>68</sup>Ga-DOTA-TOC positron emission tomography (PET)/CT imaging. We sought to compare and correlate the uptake of fluorodeoxyglucose (FDG) and DOTA-NOC in undifferentiated NPC to ascertain the possible role of <sup>68</sup>Ga-DOTA-NOC PET/CT as a new imaging biomarker and to assess whether targeted peptide receptor radionuclide therapy is a feasible treatment option. Methods: After obtaining approval from our institutional review board, 4 patients with biopsy proven nonkeratinizing undifferentiated NPC who had just undergone routine staging/restaging <sup>18</sup>F-FDG PET/CT imaging were prospectively and consecutively recruited for <sup>68</sup>Ga-DOTA-NOC PET/CT imaging. Of these 4 patients, 3 were newly diagnosed with untreated NPC, whereas 1 patient was diagnosed with a case of recurrent NPC with previous treatment. These patients subsequently underwent <sup>68</sup>Ga-DOTA-NOC PET/CT within 10 days from the <sup>18</sup>F-FDG PET/CT to ensure lesion comparability. Tracer uptake in tumor lesions were assessed visually and semiquantitatively by measuring maximum standardized uptake values (SUVmax). Results: There were 12 FDG-avid lesions of which 7 showed avid uptake of DOTA-NOC greater than liver uptake, whereas 5 showed low uptake of DOTA-NOC less than liver uptake. Subset analysis of the FDG-avid lesions at the primary and recurrent sites showed that all the FDG-avid primary tumors in the nasopharynx showed avid uptake of DOTA-NOC. On the contrary, the case of recurrent NPC showed avid FDG uptake but low DOTA-NOC uptake. Subset analysis of the suspicious FDG-avid cervical lymph nodes showed that 50% of them demonstrated avid DOTA-NOC uptake greater than liver uptake, whereas the remaining demonstrated low-grade DOTA-NOC uptake less than liver uptake. The 2 subcentimeter cervical lymph nodes that showed low-grade uptake of FDG lower than mediastinal blood pool activity were deemed to be reactive/inflammatory and showed low-grade uptake of DOTA-NOC. Conclusion: This study highlights the potential of <sup>68</sup>Ga-DOTA-peptide PET/CT as a new molecular biomarker for newly diagnosed undifferentiated NPC, and less so for recurrent NPC and metastatic nodes. This potentially opens up new diagnostic and therapeutic options in the management of undifferentiated NPC.

Original languageEnglish
JournalHead and Neck
DOIs
Publication statusAccepted/In press - 2015
Externally publishedYes

Fingerprint

Biomarkers
Positron-Emission Tomography
Carcinoma
Liver
Fluorodeoxyglucose F18
Lymph Nodes
Nasopharyngeal carcinoma
peptide A
Somatostatin Receptors
Peptide Receptors
Nasopharynx
Research Ethics Committees
Therapeutics
Autoradiography
Radioisotopes
Radionuclide Imaging
Neoplasms
Biopsy
Peptides
68Ga-DOTANOC

Keywords

  • <sup>18</sup>FDG positron emission tomography (PET)/CT
  • <sup>68</sup>Ga-DOTA-peptide
  • Nasopharyngeal carcinoma
  • Somatostatin receptors

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Khor, L. K., Loi, H. Y., Sinha, A. K., Tong, K. T., Goh, B. C., Loh, K. S., & Lu, S. J. (Accepted/In press). <sup>68</sup>Ga-DOTA-peptide: A novel molecular biomarker for nasopharyngeal carcinoma. Head and Neck. https://doi.org/10.1002/hed.24164

<sup>68</sup>Ga-DOTA-peptide : A novel molecular biomarker for nasopharyngeal carcinoma. / Khor, Lih Kin; Loi, Hoi Yin; Sinha, Arvind Kumar; Tong, Kian Ti; Goh, Boon Cher; Loh, Kwok Seng; Lu, Suat Jin.

In: Head and Neck, 2015.

Research output: Contribution to journalArticle

Khor, Lih Kin ; Loi, Hoi Yin ; Sinha, Arvind Kumar ; Tong, Kian Ti ; Goh, Boon Cher ; Loh, Kwok Seng ; Lu, Suat Jin. / <sup>68</sup>Ga-DOTA-peptide : A novel molecular biomarker for nasopharyngeal carcinoma. In: Head and Neck. 2015.
@article{3b9aad579fe9496490c59ab710338fd1,
title = "68Ga-DOTA-peptide: A novel molecular biomarker for nasopharyngeal carcinoma",
abstract = "Background: Increased somatostatin receptor (SSTR) expression in patients with undifferentiated nasopharyngeal carcinoma (NPC) has been demonstrated with receptor autoradiography, 111In-Octreotide scintigraphy, and 68Ga-DOTA-TOC positron emission tomography (PET)/CT imaging. We sought to compare and correlate the uptake of fluorodeoxyglucose (FDG) and DOTA-NOC in undifferentiated NPC to ascertain the possible role of 68Ga-DOTA-NOC PET/CT as a new imaging biomarker and to assess whether targeted peptide receptor radionuclide therapy is a feasible treatment option. Methods: After obtaining approval from our institutional review board, 4 patients with biopsy proven nonkeratinizing undifferentiated NPC who had just undergone routine staging/restaging 18F-FDG PET/CT imaging were prospectively and consecutively recruited for 68Ga-DOTA-NOC PET/CT imaging. Of these 4 patients, 3 were newly diagnosed with untreated NPC, whereas 1 patient was diagnosed with a case of recurrent NPC with previous treatment. These patients subsequently underwent 68Ga-DOTA-NOC PET/CT within 10 days from the 18F-FDG PET/CT to ensure lesion comparability. Tracer uptake in tumor lesions were assessed visually and semiquantitatively by measuring maximum standardized uptake values (SUVmax). Results: There were 12 FDG-avid lesions of which 7 showed avid uptake of DOTA-NOC greater than liver uptake, whereas 5 showed low uptake of DOTA-NOC less than liver uptake. Subset analysis of the FDG-avid lesions at the primary and recurrent sites showed that all the FDG-avid primary tumors in the nasopharynx showed avid uptake of DOTA-NOC. On the contrary, the case of recurrent NPC showed avid FDG uptake but low DOTA-NOC uptake. Subset analysis of the suspicious FDG-avid cervical lymph nodes showed that 50{\%} of them demonstrated avid DOTA-NOC uptake greater than liver uptake, whereas the remaining demonstrated low-grade DOTA-NOC uptake less than liver uptake. The 2 subcentimeter cervical lymph nodes that showed low-grade uptake of FDG lower than mediastinal blood pool activity were deemed to be reactive/inflammatory and showed low-grade uptake of DOTA-NOC. Conclusion: This study highlights the potential of 68Ga-DOTA-peptide PET/CT as a new molecular biomarker for newly diagnosed undifferentiated NPC, and less so for recurrent NPC and metastatic nodes. This potentially opens up new diagnostic and therapeutic options in the management of undifferentiated NPC.",
keywords = "<sup>18</sup>FDG positron emission tomography (PET)/CT, <sup>68</sup>Ga-DOTA-peptide, Nasopharyngeal carcinoma, Somatostatin receptors",
author = "Khor, {Lih Kin} and Loi, {Hoi Yin} and Sinha, {Arvind Kumar} and Tong, {Kian Ti} and Goh, {Boon Cher} and Loh, {Kwok Seng} and Lu, {Suat Jin}",
year = "2015",
doi = "10.1002/hed.24164",
language = "English",
journal = "Head and Neck",
issn = "1043-3074",
publisher = "John Wiley and Sons Inc.",

}

TY - JOUR

T1 - 68Ga-DOTA-peptide

T2 - A novel molecular biomarker for nasopharyngeal carcinoma

AU - Khor, Lih Kin

AU - Loi, Hoi Yin

AU - Sinha, Arvind Kumar

AU - Tong, Kian Ti

AU - Goh, Boon Cher

AU - Loh, Kwok Seng

AU - Lu, Suat Jin

PY - 2015

Y1 - 2015

N2 - Background: Increased somatostatin receptor (SSTR) expression in patients with undifferentiated nasopharyngeal carcinoma (NPC) has been demonstrated with receptor autoradiography, 111In-Octreotide scintigraphy, and 68Ga-DOTA-TOC positron emission tomography (PET)/CT imaging. We sought to compare and correlate the uptake of fluorodeoxyglucose (FDG) and DOTA-NOC in undifferentiated NPC to ascertain the possible role of 68Ga-DOTA-NOC PET/CT as a new imaging biomarker and to assess whether targeted peptide receptor radionuclide therapy is a feasible treatment option. Methods: After obtaining approval from our institutional review board, 4 patients with biopsy proven nonkeratinizing undifferentiated NPC who had just undergone routine staging/restaging 18F-FDG PET/CT imaging were prospectively and consecutively recruited for 68Ga-DOTA-NOC PET/CT imaging. Of these 4 patients, 3 were newly diagnosed with untreated NPC, whereas 1 patient was diagnosed with a case of recurrent NPC with previous treatment. These patients subsequently underwent 68Ga-DOTA-NOC PET/CT within 10 days from the 18F-FDG PET/CT to ensure lesion comparability. Tracer uptake in tumor lesions were assessed visually and semiquantitatively by measuring maximum standardized uptake values (SUVmax). Results: There were 12 FDG-avid lesions of which 7 showed avid uptake of DOTA-NOC greater than liver uptake, whereas 5 showed low uptake of DOTA-NOC less than liver uptake. Subset analysis of the FDG-avid lesions at the primary and recurrent sites showed that all the FDG-avid primary tumors in the nasopharynx showed avid uptake of DOTA-NOC. On the contrary, the case of recurrent NPC showed avid FDG uptake but low DOTA-NOC uptake. Subset analysis of the suspicious FDG-avid cervical lymph nodes showed that 50% of them demonstrated avid DOTA-NOC uptake greater than liver uptake, whereas the remaining demonstrated low-grade DOTA-NOC uptake less than liver uptake. The 2 subcentimeter cervical lymph nodes that showed low-grade uptake of FDG lower than mediastinal blood pool activity were deemed to be reactive/inflammatory and showed low-grade uptake of DOTA-NOC. Conclusion: This study highlights the potential of 68Ga-DOTA-peptide PET/CT as a new molecular biomarker for newly diagnosed undifferentiated NPC, and less so for recurrent NPC and metastatic nodes. This potentially opens up new diagnostic and therapeutic options in the management of undifferentiated NPC.

AB - Background: Increased somatostatin receptor (SSTR) expression in patients with undifferentiated nasopharyngeal carcinoma (NPC) has been demonstrated with receptor autoradiography, 111In-Octreotide scintigraphy, and 68Ga-DOTA-TOC positron emission tomography (PET)/CT imaging. We sought to compare and correlate the uptake of fluorodeoxyglucose (FDG) and DOTA-NOC in undifferentiated NPC to ascertain the possible role of 68Ga-DOTA-NOC PET/CT as a new imaging biomarker and to assess whether targeted peptide receptor radionuclide therapy is a feasible treatment option. Methods: After obtaining approval from our institutional review board, 4 patients with biopsy proven nonkeratinizing undifferentiated NPC who had just undergone routine staging/restaging 18F-FDG PET/CT imaging were prospectively and consecutively recruited for 68Ga-DOTA-NOC PET/CT imaging. Of these 4 patients, 3 were newly diagnosed with untreated NPC, whereas 1 patient was diagnosed with a case of recurrent NPC with previous treatment. These patients subsequently underwent 68Ga-DOTA-NOC PET/CT within 10 days from the 18F-FDG PET/CT to ensure lesion comparability. Tracer uptake in tumor lesions were assessed visually and semiquantitatively by measuring maximum standardized uptake values (SUVmax). Results: There were 12 FDG-avid lesions of which 7 showed avid uptake of DOTA-NOC greater than liver uptake, whereas 5 showed low uptake of DOTA-NOC less than liver uptake. Subset analysis of the FDG-avid lesions at the primary and recurrent sites showed that all the FDG-avid primary tumors in the nasopharynx showed avid uptake of DOTA-NOC. On the contrary, the case of recurrent NPC showed avid FDG uptake but low DOTA-NOC uptake. Subset analysis of the suspicious FDG-avid cervical lymph nodes showed that 50% of them demonstrated avid DOTA-NOC uptake greater than liver uptake, whereas the remaining demonstrated low-grade DOTA-NOC uptake less than liver uptake. The 2 subcentimeter cervical lymph nodes that showed low-grade uptake of FDG lower than mediastinal blood pool activity were deemed to be reactive/inflammatory and showed low-grade uptake of DOTA-NOC. Conclusion: This study highlights the potential of 68Ga-DOTA-peptide PET/CT as a new molecular biomarker for newly diagnosed undifferentiated NPC, and less so for recurrent NPC and metastatic nodes. This potentially opens up new diagnostic and therapeutic options in the management of undifferentiated NPC.

KW - <sup>18</sup>FDG positron emission tomography (PET)/CT

KW - <sup>68</sup>Ga-DOTA-peptide

KW - Nasopharyngeal carcinoma

KW - Somatostatin receptors

UR - http://www.scopus.com/inward/record.url?scp=84939242222&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84939242222&partnerID=8YFLogxK

U2 - 10.1002/hed.24164

DO - 10.1002/hed.24164

M3 - Article

AN - SCOPUS:84939242222

JO - Head and Neck

JF - Head and Neck

SN - 1043-3074

ER -