Correlation between NEN Bone Metastasis Performance and Tumor Proliferation: 112 Cases of [68Ga]Ga-DOTA-TATE Result Analysis.

ABSTRACT

PURPOSE: This study aimed to analyze neuroendocrine neoplasm (NEN) bone metastasis (BM) and gallium-68 (68Ga)-DOTA-TATE performance and to explore their correlation with the immunohistochemical proliferation index (Ki-67). PROCEDURES A total of 112 patients with BMs were screened from 1082 NEN patients who underwent [68Ga]Ga-DOTA-TATE imaging. All patients had pathological results, and BMs were affirmed by clinical/imaging follow-up and/or histopathology. The maximum standard uptake value (SUVmax) ratio of BM to normal bone determined for each patient was used in the final analysis. RESULTS: The incidence rate of BMs in NENs was 10.35%. BMs occurred in the spine (75%), pelvis (72.3%), ribs (58%), clavicles and scapulae (41.1%), limbs (37.5%), and skull (28.6%). Most cases were associated with liver metastases (70.5%) and lymph node metastases (65.2%) simultaneously. The SUVmax ratio of G3b (median ratio = 3.77, Ki-67 >55%) was significantly lower than that of G1 (11.43, Ki-67 ≤2%) and G2a (11.15, 3% ≤ Ki-67 ≤10%) separately (p < 0.05), while no differences were found for G2b (8.5, 11% ≤ Ki-67 ≤55%) and G3a (6.64, Ki-67 >55%) groups. In the total patients, there was a significant negative correlation between the SUVmax ratio of BMs to normal bone and Ki-67 (r = -0.267, p < 0.01). According to the changes in bone density on CT scans, the cases were divided into 4 groups osteogenesis, osteolysis, no change, and a mixed group (median Ki-67 6.5%, 15%, 12%, and 22.5%). The Ki-67 values were significantly different between the osteogenesis group and the other groups (p < 0.05). CONCLUSION: BM is present in 10.35% of NEN patients and most have simultaneous liver and/or lymph node metastases. The occurrence of osteogenesis indicates relatively good differentiation, and there is a negative correlation between SUVmax ratio of BMs and NEN proliferation.