Value of the 68Ga-DOTATATE PET-CT in the diagnosis of endometriosis. A pilot study

Maxime Fastrez, M Fastrez, Fastrez M, C Artigas, Carlos Artigas, Nicolas Sirtaine, Sirtaine N, N Sirtaine, Z Wimana, Zéna Wimana, Martin Caillet, Caillet M, M Caillet, Serge Rozenberg, S Rozenberg, Flamen P, Patrick Flamen, P Flamen
European journal of obstetrics, gynecology, and reproductive biology · 2017 · vol. 212 , pp. 69–74 · doi:10.1016/j.ejogrb.2017.03.022 · PMID:28342392 · W2595731203
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This pilot study investigated the diagnostic utility of 68Ga-DOTATATE PET-CT for endometriosis.

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Abstract

ObjectiveThe non-invasive diagnosis of endometriosis remains challenging. Recent data suggested that somatostatin might be involved in its pathogenesis. High sensitive visualization of somatostatin receptors expression is possible using PET-CT imaging after the administration of a 68Ga-labeled somatostatin analog (DOTATATE) that will bind to the somatostatin receptor sub-types 2 and 5. The aim of the present study was to assess the usefulness of 68Ga-DOTATATE PET-CT in the diagnosis of endometriosis.Study designThis is a prospective, single center pilot study. A pre operative 68Ga-DOTATATE PET-CT was performed in all of the patients who presented with suspected endometriosis and who were scheduled for a laparoscopy. Surgical endometriosis staging and histopathological analysis, including somatostatin receptors SST1, 2 and 5 immunohistochemistry (IHC) of removed specimens, were confronted to the results of the 68Ga-DOTATATE PET-CT.Results12 patients were included in this study. 68Ga-DOTATATE PET-CT performed pre operatively showed increased pathologic uptake in four patients with a deep infiltrating endometriosis (DIE) recto-vaginal lesion and in another patient with an adenomyoma. Expression of SST1, 2 and 5 receptors in surgical specimens was confirmed by IHC in these five lesions. Neither superficial peritoneal endometriosis, nor ovarian endometrioma were found to show an increased pathologic uptake on 68Ga-DOTATATE PET-CT. IHC analysis confirmed that SST1, 2, and 5 receptors were not present in these lesions.ConclusionThe results observed in this small size series of patients seem to confirm expression of somatostatin receptors only in recto-vaginal DIE and focal adenomyosis lesions. The usefulness of 68Ga-DOTATATE PET-CT in the diagnosis of this entity is uncertain. Future research should concentrate on studying the role of somatostatin in the pathogenesis of DIE.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Gallium Radioisotopes Organometallic Compounds Positron Emission Tomography Computed Tomography Receptors, Somatostatin Adult Endometriosis Endometriosis Feasibility Studies Female Gallium Radioisotopes Humans Organometallic Compounds Pilot Projects Positron Emission Tomography Computed Tomography Prospective Studies Receptors, Somatostatin Vagina Vagina

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