{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:39:06Z","timestamp":1765211946335,"version":"3.46.0"},"reference-count":20,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: For completely resected well differentiated (WD) gastroenteropancreatic (GEP) NET, guidelines differ in recommendations for utilization of SSTR-based functional imaging in post-operative surveillance. While 111In-Octreotide has previously been the standard of care, imaging with 68Ga-labelled peptides has expanded in recent years due to increased sensitivity to detect smaller volume diseases and reduced costs. Though many centres have widely adopted imaging with 68Ga-labelled peptides, its role in surveillance of resected GEP NET has not been well defined. We sought to characterize current utilization of imaging with 68Ga-DOTATATE PET CT (68Ga-DOTA) for post-operative surveillance of WD GEP NET and assess the impact on clinical management. Methods: We conducted a retrospective review of all 68Ga-DOTA scans performed from April 2019 to August 2024. Inclusion criteria were age \u2265 18 years with WD grade 1 and 2 GEP NET that had undergone curative-intent surgery, had Stage I-III disease at diagnosis, and had 68Ga-DOTA post-operatively. Results: Forty-six scans met the inclusion criteria. We identified four indications for 68Ga-DOTA: (1) post-operative assessment (n = 12); (2) routine surveillance (n = 18); (3) recurrence suspected based on cross-sectional imaging (n = 10); and (4) recurrence suspected based on biochemical monitoring (n = 6). Avidity for each indication was observed in 45%, 8%, 50%, and 80%, respectively. Initiation of long-acting somatostatin analogue was the most common management following avidity. Conclusions: 68Ga-DOTA best informed clinical decision making when there was clinical suspicion for residual or metastatic disease post-operatively or based on cross-sectional imaging or biochemistry. The utility of this modality for routine surveillance appears limited.<\/jats:p>","DOI":"10.3390\/jcm14238545","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:20:29Z","timestamp":1765210829000},"page":"8545","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Utility of Gallium-68-DOTATATE PET CT in Surveillance of Resected Gastroenteropancreatic NET"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3140-6957","authenticated-orcid":false,"given":"Kirstie","family":"Lithgow","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada"},{"name":"Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB T2N 1N4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil","family":"Samnani","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3517-0910","authenticated-orcid":false,"given":"Caitlin T.","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department Surgery, University of Calgary, Calgary, AB T2N 1N4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Calgary, Calgary, AB T2N 1N4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/S1470-2045(07)70410-2","article-title":"Gastroenteropancreatic neuroendocrine tumours","volume":"9","author":"Modlin","year":"2008","journal-title":"Lancet Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.neo.2017.09.002","article-title":"Nothing but NET: A review of neuroendocrine tumors and carcinomas","volume":"19","author":"Oronsky","year":"2017","journal-title":"Neoplasia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.2967\/jnumed.116.179234","article-title":"Molecular Imaging of Gastroenteropancreatic Neuroendocrine Tumors: Current Status and Future Directions","volume":"57","author":"Deroose","year":"2016","journal-title":"J. Nucl. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.2967\/jnumed.117.191197","article-title":"(68)Ga-DOTATOC Imaging of Neuroendocrine Tumors: A Systematic Review and Metaanalysis","volume":"58","author":"Graham","year":"2017","journal-title":"J. Nucl. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1007\/s002590100639","article-title":"Biokinetics and imaging with the somatostatin receptor PET radioligand 68 Ga-DOTATOC: Preliminary data","volume":"28","author":"Hofmann","year":"2001","journal-title":"Eur. J. Nucl. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/S1536-1632(03)00038-6","article-title":"Evaluation of positron emission tomography imaging using [68Ga]-DOTA-D Phe1-Tyr3-octreotide in comparison to [111In]-DTPAOC SPECT. First results in patients with neuroendocrine tumors","volume":"5","author":"Kowalski","year":"2003","journal-title":"Mol. Imaging Biol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"508","DOI":"10.2967\/jnumed.106.035667","article-title":"68Ga-DOTA-Tyr3-octreotide PET in neuroendocrine tumors: Comparison with somatostatin receptor scintigraphy and CT","volume":"48","author":"Gabriel","year":"2007","journal-title":"J. Nucl. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1007\/s00259-007-0450-1","article-title":"Comparison of 68 Ga-DOTATOC PET and 111 In-DTPAOC (Octreoscan) SPECT in patients with neuroendocrine tumours","volume":"34","author":"Buchmann","year":"2007","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.2967\/jnumed.108.060236","article-title":"Bone metastases in patients with neuroendocrine tumor: 68Ga-DOTA-Tyr3-octreotide PET in comparison to CT and bone scintigraphy","volume":"50","author":"Putzer","year":"2009","journal-title":"J. Nucl. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"875","DOI":"10.2967\/jnumed.109.066134","article-title":"The role of 68Ga-DOTATATE PET in patients with neuroendocrine tumors and negative or equivocal findings on 111In-DTPA-octreotide scintigraphy","volume":"51","author":"Srirajaskanthan","year":"2010","journal-title":"J. Nucl. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1159\/000472717","article-title":"68Gallium DOTANOC-PET imaging in lung carcinoids: Impact on patients\u2019 management","volume":"106","author":"Lamarca","year":"2018","journal-title":"Neuroendocrinology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1001\/jamaoncol.2018.2428","article-title":"Follow-up Recommendations for Completely Resected Gastroenteropancreatic Neuroendocrine Tumors","volume":"4","author":"Singh","year":"2018","journal-title":"JAMA Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1097\/MPA.0000000000000850","article-title":"The North American Neuroendocrine Tumor Society Consensus Guidelines for Surveillance and Medical Management of Midgut Neuroendocrine Tumors","volume":"46","author":"Strosberg","year":"2017","journal-title":"Pancreas"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1159\/000458155","article-title":"ENETS Consensus Recommendations for the Standards of Care in Neuroendocrine Neoplasms: Follow-Up and Documentation","volume":"105","author":"Knigge","year":"2017","journal-title":"Neuroendocrinology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"839","DOI":"10.6004\/jnccn.2021.0032","article-title":"Neuroendocrine and Adrenal Tumors, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology","volume":"19","author":"Shah","year":"2021","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/j.annonc.2020.03.304","article-title":"Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"31","author":"Pavel","year":"2020","journal-title":"Ann. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"66","DOI":"10.2967\/jnumed.117.202275","article-title":"Appropriate Use Criteria for Somatostatin Receptor PET Imaging in Neuroendocrine Tumors","volume":"59","author":"Hope","year":"2018","journal-title":"J. Nucl. Med."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Iannuzzi, J., Yeo, C.T., Parkins, V., Ruether, D., Stewart, E., Chan, D., Pasieka, J., and Lithgow, K. (2024). Radiation Exposure from GEP NET Surveillance. Cancers, 16.","DOI":"10.3390\/cancers16020427"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.2967\/jnumed.114.144543","article-title":"68Ga-DOTATATE PET\/CT, 99mTc-HYNIC-octreotide SPECT\/CT, and whole-body MR imaging in detection of neuroendocrine tumors: A prospective trial","volume":"55","author":"Etchebehere","year":"2014","journal-title":"J. Nucl. Med."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Froelich, M.F., Schnitzer, M.L., Holzgreve, A., Gassert, F.G., Gresser, E., Overhoff, D., Schwarze, V., Fabritius, M.P., Norenberg, D., and von Munchhausen, N. (2021). Cost-Effectiveness Analysis of (68)Ga DOTA-TATE PET\/CT, (111)In-Pentetreotide SPECT\/CT and CT for Diagnostic Workup of Neuroendocrine Tumors. Diagnostics, 11.","DOI":"10.3390\/diagnostics11020334"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/23\/8545\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:34:20Z","timestamp":1765211660000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/23\/8545"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,2]]},"references-count":20,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["jcm14238545"],"URL":"https:\/\/doi.org\/10.3390\/jcm14238545","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,2]]}}}