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@ARTICLE{Herr:300156,
      author       = {F. L. Herr and C. Dascalescu and M. P. Fabritius and G. T.
                      Sheikh and M. J. Zacherl and V. Wenter and L. M. Unterrainer
                      and M. Brendel$^*$ and A. Holzgreve and C. J. Auernhammer
                      and C. Spitzweg and T. Burkard and J. Ricke and M. M. Heimer
                      and C. C. Cyran},
      title        = {{PET}- and {CT}-{B}ased {I}maging {C}riteria for {R}esponse
                      {A}ssessment of {G}astroenteropancreatic {N}euroendocrine
                      {T}umors {U}nder {R}adiopharmaceutical {T}herapy.},
      journal      = {Journal of nuclear medicine},
      volume       = {66},
      number       = {5},
      issn         = {0097-9058},
      address      = {New York, NY},
      publisher    = {Soc.},
      reportid     = {DKFZ-2025-00642},
      pages        = {726-731},
      year         = {2025},
      note         = {2025 May 1;66(5):726-731},
      abstract     = {Despite well-documented limitations, current guidelines
                      recommend the use of size-based RECIST 1.1 for response
                      assessment of gastroenteropancreatic neuroendocrine tumors
                      (GEP-NETs) under radiopharmaceutical therapy (RPT). We
                      hypothesize that functional criteria are superior to RECIST
                      1.1 for response assessment and progression-free survival
                      (PFS) prediction, and molecular scores can be used in
                      prognosticating PFS. Methods: This single-center,
                      retrospective study included 178 patients with GEP-NETs (G1
                      and G2) who were treated with at least 2 consecutive cycles
                      of RPT with [177Lu]Lu-DOTATATE and who underwent
                      somatostatin receptor PET/CT at baseline and after 2 cycles
                      of RPT (follow-up). PFS was defined as the time between
                      baseline and clinical progression, as reported by a GEP-NET
                      multidisciplinary tumor board (MDT) assessment or reported
                      death. The differences in categorization and PFS between
                      RECIST 1.1, Choi (functional criteria), and the MDT were
                      evaluated, and 3-y PFS with MDT defined PFS as the
                      reference. The predictive values of the different scores in
                      somatostatin receptor standardized reporting and data system
                      and Krenning (molecular scores) for PFS were analyzed.
                      Results: Choi criteria classified a higher number of
                      patients as having progressive disease and partial response
                      and a lower number of patients as having stable disease
                      compared with RECIST 1.1 (P < 0.01). The PFS of patients
                      with progressive disease according to RECIST 1.1 and Choi
                      criteria was shorter than that of patients with stable
                      disease and partial response (P < 0.05). Choi criteria
                      showed a nonsignificantly higher concordance with the MDT
                      than with RECIST 1.1. There was a shift in category from a
                      Krenning score of 4 to a score of 3 between baseline and
                      follow-up (P < 0.01). At baseline, a Krenning score of 3 was
                      associated with a shorter median PFS compared with a score
                      of 4 (P < 0.05). Conclusion: In addition to RECIST 1.1,
                      further PET- and CT-based imaging criteria have the
                      potential to assess response and predict PFS in patients
                      with GEP-NETs undergoing RPT. Our data support the
                      assumption to use Choi criteria for prediction of PFS and
                      agreement in response assessment. At baseline, the Krenning
                      score can be used to predict therapy response after 2 cycles
                      of RPT.},
      keywords     = {GEP-NET (Other) / RPT (Other) / SSTR PET/CT (Other) / human
                      studies (Other) / response criteria (Other)},
      cin          = {MU01},
      ddc          = {610},
      cid          = {I:(DE-He78)MU01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40147845},
      doi          = {10.2967/jnumed.124.268621},
      url          = {https://inrepo02.dkfz.de/record/300156},
}